Aims. The aim of this study was to evaluate the association between chondral
Abstract. Background. Fracture dislocation of the knee involves disruption of knee ligaments with associated tibial plateau fracture. If these
Abstract. Introduction. High posterior tibial slope (PTS) has been recognised as a risk factor for anterior cruciate ligament rupture and graft failure. This prospective randomised study looked at intra-operative findings of concomitant intra-articular meniscal and chondral
We retrospectively reviewed the hospital records of 68 patients who had been referred with an
We have investigated iatrogenic popliteal artery
injuries (PAI) during non arthroplasty knee surgery regarding mechanism
of
Popliteal artery
Most
While
Aims. The aim of this study was to investigate the long-term clinical
and radiological outcome of patients who suffer recurrent injuries
to the anterior cruciate ligament (ACL) after reconstruction and
require revision surgery. Patients and Methods. From a consecutive series of 200 patients who underwent primary
reconstruction following rupture of the ACL, we identified 36 who
sustained a further rupture, 29 of whom underwent revision surgery.
Patients were reviewed prospectively at one, two, seven, 15 and
about 20 years after their original surgery. Primary outcome measures
were the number of further ruptures, the posterior tibial slope
(PTS), and functional and radiological outcomes. These were compared
with a gender and age matched cohort of patients who underwent primary
ACL reconstruction only. Results. At a mean follow-up of 18.3 years (14.3 to 20.2), 29 patients
had undergone revision surgery and within this revision group 11
had sustained more than three ruptures of the ACL (3 to 6). The
mean age at the time of revision reconstruction was 26.4 years (14
to 54). The mean PTS was significantly higher in those patients
who suffered a further
Introduction. Patients with solid organ transplant have been shown to have increased risk of complications following TKA compared to non-transplant patients. The risk of AKI in KTx is reported to be as high as 15.6 % and associated with increased morbidity, and length of stay (LOS). Our aim was to determine the incidence of AKI in KTx undergoing primary and revision TKA and to identify risk factors for its occurrence and its effect on allograft function 1 year postoperatively. Methods. Using the orthopedic and transplant databases we designed a case-control study of 82 patients undergoing 101 TKA between 2000 and 2018 at our institution. The average age at surgery was 65 years (range 35–83); 58% male and 98% white. AKI was defined per KIDGO guidelines. Results. The incidence of AKI was 7 % after primary and revision TKA. Median baseline kidney function (eGFR) was lower in the AKI group (33 vs. 53 ml/min, p=0.003). All AKI were stage 1 as per AKIN criteria. LOS was 4.9 vs. 3.5 days for those with and without AKI (p= 0.04). There was no significant difference between anesthesia time, pressor requirements, estimated blood loss, transfusion, or amount of fluid administered between the 2 groups. At one year, there was a drop in eGFR in AKI patients compared to non-AKI patients (− 14 vs. 0 ml/min (p=0.042). Discussion. The incidence of AKI after TKA in KTx was 7 % in this cohort and associated with longer hospitalization. AKI occurred in patients with lower baseline eGFR and there were no other identified risk factors. Despite the
Loss of proprioception following an anterior
cruciate ligament (ACL)
We reviewed the relationship between the pattern of damage to the posterolateral corner of the knee and the position of the common peroneal nerve in 54 consecutive patients with posterolateral corner disruption requiring surgery. We found that 16 of the 18 patients with biceps avulsions or avulsion-fracture of the fibular head had a displaced common peroneal nerve. The nerve was pulled anteriorly with the biceps tendon. None of the 34 proximal
The role of arthroscopy in the treatment of soft-tissue
injuries associated with proximal tibial fractures remains debatable.
Our hypothesis was that MRI over-diagnoses clinically relevant associated
soft-tissue
The objectives of this study were to compare the systemic inflammatory reaction, localised thermal response and macroscopic soft tissue injury outcomes in conventional jig-based total knee arthroplasty (conventional TKA) versus robotic total knee arthroplasty (robotic TKA). This prospective randomised controlled trial included 30 patients with symptomatic knee osteoarthritis undergoing conventional TKA versus robotic TKA. Predefined serum markers of inflammation and localised knee temperature were collected preoperatively and postoperatively at 6 hours, day 1, day 2, day 7, and day 28 following TKA. Blinded observers used the Macroscopic Soft Tissue Injury (MASTI) classification system to grade intraoperative periarticular soft tissue injury and bone trauma. Plain radiographs were used to assess the accuracy of achieving the planned limb alignment and implant positioning in both treatment groups.Introduction
Methods
We have measured anterior and posterior displacement in 563 normal knees and 487 knees with chronic deficiency of the anterior cruciate ligament (ACL). We performed stress radiography using a simple apparatus which maintained the knee at 20° of flexion while a 9 kg load was applied. There was no significant difference in posterior translation dependent on the condition of the ACL. Measurement of anterior translation in the medial compartment proved to be more reliable than in the lateral compartment for the diagnosis of rupture of the ACL, with better specificity, sensitivity and predictive values. We have classified anterior laxity based on the differential anterior translation of the medial compartment and identified four grades in each of which we can further distinguish four subgrades for laxity of the lateral compartment. Within each of these subgroups, either internal or external rotation may dominate and sometimes there is a major translation of both compartments. Radiological evaluation of displacement of the knee in 20° of flexion provides conclusive evidence of rupture of the ACL. A detailed study of pathological displacement is the basis for a classification of laxity. It is then possible to decide for each type of laxity, the surgical treatment which is specifically adapted to the lesion, and to define a reference value for judging outcome.
We investigated the role of a functional brace worn for four months in the treatment of patients with an acute isolated tear of the posterior cruciate ligament to determine whether reduction of the posterior tibial translation during the healing period would give an improved final position of the tibia. The initial and follow-up stability was tested by Rolimeter arthrometry and radiography. The clinical outcome was evaluated using the Lysholm score, the Tegner score and the International Knee Documentation Committee scoring system at follow-up at one and two years. In all, 21 patients were studied, 21 of whom had completed one-year and 17 a two-year follow-up. The initial mean posterior sag (Rolimeter measurement) of 7.1 mm (5 to 10) was significantly reduced after 12 months to a mean of 2.3 mm (0 to 6, p <
0.001) and to a mean of 3.2 mm (2 to 7, p = 0.001) after 24 months. Radiological measurement gave similar results. The mean pre-injury Lysholm score was normal at 98 (95 to 100). At follow-up, a slight decrease in the mean values was observed to 94.0 (79 to 100, p = 0.001) at one year and 94.0 (88 to 100, p = 0.027, at two years). We concluded that the posterior cruciate ligament has an intrinsic healing capacity and, if the posteriorly translated tibia is reduced to a physiological position, it can heal with less attentuation. The applied treatment produces a good to excellent functional result.
Abstract. Introduction. Knee dislocations (KDs) are complex
Aims. Multiligament knee injuries (MLKI) are devastating
Aims. Periprosthetic fractures (PPFs) around the knee are challenging
Abstract. Introduction. Traumatic knee dislocations are devastating