Aims. The aim of this study was to report the pooled prevalence of post-traumatic osteoarthritis (PTOA) and examine whether the risk of developing PTOA after
Aims. The aim of this study was to estimate the incremental use of resources, costs, and quality of life outcomes associated with surgical reconstruction compared to rehabilitation for long-standing
Aims. The objectives of this study were to assess the effect of
Aims. This study aims to determine the proportion of patients with end-stage knee osteoarthritis (OA) possibly suitable for partial (PKA) or combined partial knee arthroplasty (CPKA) according to patterns of full-thickness cartilage loss and
Aims. The aim of this prospective study was to assess the long-term clinical, radiological, functional, and quality of life (QoL)-related outcome of patients treated with the synthetic Ligament Advanced Reinforcement System (LARS) device for
We sought to determine whether smoking affected the outcome of reconstruction of the
We reviewed 183 patients who had undergone reconstruction of the
There is a trend towards the use of double-bundle techniques for the reconstruction of the
Aims.
Abnormal knee kinematics following reconstruction
of the
We report the effects of local administration of osteogenic protein-1 on the biomechanical properties of the overstretched
While injury to the posterolateral corner is accepted as a relatively common occurrence associated with rupture of the
We present the results of 17 children of Tanner stage 1 or 2 who underwent reconstruction of the
Aims. Different methods of
The records of patients aged 50 years or over who underwent primary reconstruction of the
Delayed rather than early reconstruction of the
Ten patients are reported who had sustained a partial rupture of the
We report the clinical outcome and findings at
second-look arthroscopy of 216 patients (mean age 25 years (11 to 58))
who underwent
We carried out a prospective study of 71 patients who had undergone reconstruction of the
This study evaluated the results of a physeal-sparing technique of intra-articular
In the UK, the agricultural, military, and construction sectors have stringent rules about the use of hearing protection due to the risk of noise-induced hearing loss. Orthopaedic staff may also be at risk due to the use of power tools. The UK Health and Safety Executive (HSE) have clear standards as to what are deemed acceptable occupational levels of noise on A-weighted and C-weighted scales. The aims of this review were to assess the current evidence on the testing of exposure to noise in orthopaedic operating theatres to see if it exceeds these regulations. A search of PubMed and EMBASE databases was conducted using PRISMA guidelines. The review was registered prospectively in PROSPERO. Studies which assessed the exposure to noise for orthopaedic staff in operating theatres were included. Data about the exposure to noise were extracted from these studies and compared with the A-weighted and C-weighted acceptable levels described in the HSE regulations.Aims
Methods
We reviewed a single-surgeon series of 300 athletic patients who had undergone reconstruction of the
We used single-photon emission computed tomography (SPECT) to determine the long-term risk of degenerative change after reconstruction of the
We have investigated the changes in anterior laxity of the knee in response to direct electrical stimulation of eight normal and 45 reconstructed
We have investigated whether cells derived from haemarthrosis caused by injury to the
The clinical and radiological features of 12 knees (10 patients) with congenital absence of the
A total of 108 patients with unilateral instability of the knee, associated with rupture of the
The revascularisation and remodelling of allografts used to replace the
We identified a series of 128 patients who had unilateral open reconstruction of the
There is little evidence examining the relationship between anatomical landmarks, radiological placement of the tunnels and long-term clinical outcomes following
It has been suggested that an increased posterior
tibial slope (PTS) and a narrow notch width index (NWI) increase
the risk of
In a prospective study, 41 consecutive patients with a partial tear of the
We reviewed 195 knees in 167 patients at least 20 years after a rim-preserving meniscectomy. They were considered in two groups: 102 knees had had an intact
We have measured anterior and posterior displacement in 563 normal knees and 487 knees with chronic deficiency of the
We studied bone-tendon healing using immunohistochemical methods in a rabbit model. Reconstruction of the
We examined whether somatosensory evoked potentials (SEPs) were detectable after direct electrical stimulation of injured, reconstructed and normal
In an animal model we determined the strength of
Sixty-five knees were subjected to a kinematic analysis using the instant-centre technique in order to determine the effect of deficiency of the
The use of platelet-rich plasma (PRP) as an adjuvant
to tissue repair is gaining favour in orthopaedic surgery. Tunnel widening
after
Our objectives were to establish the envelope of passive movement and to demonstrate the kinematic behaviour of the knee during standard clinical tests before and after reconstruction of the
A total of 30 patients who underwent endoscopic reconstruction of the
A group of 40 patients with unstable knees due to a combination of a meniscal tear with a rupture of the
We randomised 31 patients with acute tears of the
The operative treatment of lesions of the
We have undertaken a randomized clinical trial comparing two methods of reconstruction of the
A total of 90 patients with an isolated rupture of the
In a two-centre study, 164 patients with unilateral instability of the
Dynamic muscle-tendon substitution for acute anterior cruciate deficiency in the dog was studied using the semimembranosus muscle-tendon. Nineteen mongrel dogs each had a semimembranosus transfer in one knee; as a control, the
The physiological role of mechanoreceptors in the
In a study combining tissue mechanics and fracture morphology for the first time, we examined the ruptured surfaces of
In a prospective seven-year study, we treated 32 patients with partial ruptures of the
Four types of prosthetic replacement for the
A total of 60 children and adolescents with rupture of the
We assessed proprioception in the knee using the angle reproduction test in 20 healthy volunteers, ten patients with acute anterior instability and 20 patients with chronic anterior instability after reconstruction of the
We describe the use of allogeneic human tendon as an intra-articular replacement for the
The loss of full muscle activation contributes to weakness of the quadriceps muscle in patients with deficiency of the
A study was undertaken to determine whether a significantly different clinical outcome could be expected following nonoperative treatment of acute partial
We have determined whether somatosensory evoked potentials (SEPs) were detectable after direct mechanical stimulation of normal, injured and reconstructed
Deficiency of the
Failure of conservative treatment is the usual indication for the reconstruction of a knee with deficiency of the
Thirty-nine patients underwent reconstruction of the
We describe the results of conservative treatment for complete midsubstance tears of the
In 100 consecutive patients with chronic deficiency of the
Cryopreserved patellar tendon allografts are often recommended for reconstruction of
We describe 74 patients with disabling instability of the knee due to isolated anterior cruciate deficiency. None responded to conservative measures or correction of internal derangements. All patients were treated by replacement of the
This work studied the fibre bundle anatomy of the
Many methods of reconstruction for ACL deficiency have been described, but little is known about their biomechanical properties. We examined extra-articular (EA), intra-articular (IA) and combined (EA+IA) reconstructions in ten cadaver knees after the ACL had been ruptured by the performance of a rapid anterior drawer movement. Stability at each stage before and after rupture and reconstruction was tested by anterior drawer, Lachman, varus-valgus and tibial rotation tests. Both IA and IA+EA reconstructions restored normal stability, while EA reconstructions improved stability but did not restore it to normal. The addition of an EA procedure to an IA procedure made no difference to knee stability. We conclude that in cases of isolated ACL deficiency there is no biomechanical basis for EA reconstruction, either alone or in addition to an IA reconstruction.
We report a review of 54 patients with chronic anterior cruciate ligament rupture treated by patellar-quadriceps tendon graft augmented with polypropylene braid (Kennedy-LAD). The femoral placement of the graft was randomised to either a modified over-the-top (OTT) or a tunnel position obtained by an isometric drill guide (ISO). At the two-year follow-up both procedures had resulted in improvement of subjective knee function and activity level. Stereoradiographic measurements showed reduction of anteroposterior laxity to near normal in about one-third of the patients, but muscle strength and objective functional performance showed little or no changes. The OTT group had better subjective knee function. We were unable to confirm the theoretical advantages of the use of the drill guide, partly because it provided a tibial tunnel which was too anterior.
The
Aims. The aim of this study was to compare a bicruciate-retaining (BCR) total knee arthroplasty (TKA) with a posterior cruciate-retaining (CR) TKA design in terms of kinematics, measured using fluoroscopy and stability as micromotion using radiostereometric analysis (RSA). Methods. A total of 40 patients with end-stage osteoarthritis were included in this randomized controlled trial. All patients performed a step-up and lunge task in front of a monoplane fluoroscope one year postoperatively. Femorotibial contact point (CP) locations were determined at every flexion angle and compared between the groups. RSA images were taken at baseline, six weeks, three, six, 12, and 24 months postoperatively. Clinical and functional outcomes were compared postoperatively for two years. Results. The BCR-TKA demonstrated a kinematic pattern comparable to the natural knee’s screw-home mechanism in the step-up task. In the lunge task, the medial CP of the BCR-TKA was more anterior in the early flexion phase, while laterally the CP was more posterior during the entire movement cycle. The BCR-TKA group showed higher tibial migration. No differences were found for the clinical and functional outcomes. Conclusion. The BCR-TKA shows a different kinematic pattern in early flexion/late extension compared to the CR-TKA. The difference between both implants is mostly visible in the flexion phase in which the
Aims. The best surgical strategy for the management of displaced bucket-handle (BH) meniscal tears in an
Aims. The aim of this study was to evaluate the association between chondral injury and interval from
Aims.
Aims. The patient-acceptable symptom state (PASS) is a level of wellbeing, which is measured by the patient. The aim of this study was to determine if the proportion of patients who achieved an acceptable level of function (PASS) after medial unicompartmental knee arthroplasty (UKA) was different based on the status of the
Aims.
The options for treatment of the young active patient with isolated symptomatic osteoarthritis of the medial compartment and pre-existing deficiency of the
Aims. Although knee osteoarthritis (OA) is diagnosed and monitored radiologically, actual full-thickness cartilage loss (FTCL) has rarely been correlated with radiological classification. This study aims to analyze which classification system correlates best with FTCL and to assess their reliability. Methods. A prospective study of 300 consecutive patients undergoing unilateral total knee arthroplasty (TKA) for OA (mean age 69 years (44 to 91; standard deviation (SD) 9.5), 178 (59%) female). Two blinded examiners independently graded preoperative radiographs using five common systems: Kellgren-Lawrence (KL); International Knee Documentation Committee (IKDC); Fairbank; Brandt; and Ahlbäck. Interobserver agreement was assessed using the intraclass correlation coefficient (ICC). Intraoperatively,
Aims. The aim of this study was to investigate the incidence, risk factors, and outcome of venous thromboembolism (VTE) following
Aim. Mesenchymal stem cells (MSCs) have several properties that may support their use as an early treatment option for osteoarthritis (OA). This study investigated the role of multiple injections of allogeneic bone marrow-derived stem cells (BMSCs) to alleviate the progression of osteoarthritic changes in the various structures of the mature rabbit knee in an
There is a disparity in sport-related injuries between sexes, with females sustaining non-contact musculoskeletal injuries at a higher rate. Anterior cruciate ligament ruptures are between two and eight times more common than in males, and females also have a higher incidence of ankle sprains, patellofemoral pain, and bone stress injuries. The sequelae of such injuries can be devastating to an athlete, resulting in time out of sport, surgery, and the early onset of osteoarthritis. It is important to identify the causes of this disparity and introduce prevention programmes to reduce the incidence of these injuries. A natural difference reflects the effect of reproductive hormones in females, which have receptors in certain musculoskeletal tissues. Relaxin increases ligamentous laxity. Oestrogen decreases the synthesis of collagen and progesterone does the opposite. Insufficient diet and intensive training can lead to menstrual irregularities, which are common in female athletes and result in injury, whereas oral contraception may have a protective effect against certain injuries. It is important for coaches, physiotherapists, nutritionists, doctors, and athletes to be aware of these issues and to implement preventive measures. This annotation explores the relationship between the menstrual cycle and orthopaedic sports injuries in pre-menopausal females, and proposes recommendations to mitigate the risk of sustaining these injuries. Cite this article:
Aims. To investigate the risk factors for progression of articular
cartilage damage after anatomical
Aims. The aim of this study was to assess the effect of posterior cruciate ligament (PCL) resection on flexion-extension gaps, mediolateral soft-tissue laxity, fixed flexion deformity (FFD), and limb alignment during posterior-stabilized (PS) total knee arthroplasty (TKA). Patients and Methods. This prospective study included 110 patients with symptomatic osteoarthritis of the knee undergoing primary robot-assisted PS TKA. All operations were performed by a single surgeon using a standard medial parapatellar approach. Optical motion capture technology with fixed femoral and tibial registration pins was used to assess gaps before and after PCL resection in extension and 90° knee flexion. Measurements were made after excision of the
This study aims to identify the top unanswered research priorities in the field of knee surgery using consensus-based methodology. Initial research questions were generated using an online survey sent to all 680 members of the British Association for Surgery of the Knee (BASK). Duplicates were removed and a longlist was generated from this scoping exercise by a panel of 13 experts from across the UK who provided oversight of the process. A modified Delphi process was used to refine the questions and determine a final list. To rank the final list of questions, each question was scored between one (low importance) and ten (high importance) in order to produce the final list.Aims
Methods
Cite this article:
Implantation of ultra-purified alginate (UPAL) gel is safe and effective in animal osteochondral defect models. This study aimed to examine the applicability of UPAL gel implantation to acellular therapy in humans with cartilage injury. A total of 12 patients (12 knees) with symptomatic, post-traumatic, full-thickness cartilage lesions (1.0 to 4.0 cm2) were included in this study. UPAL gel was implanted into chondral defects after performing bone marrow stimulation technique, and assessed for up to three years postoperatively. The primary outcomes were the feasibility and safety of the procedure. The secondary outcomes were self-assessed clinical scores, arthroscopic scores, tissue biopsies, and MRI-based estimations.Aims
Methods
The epiphyseal approach to a chondroblastoma of the intercondylar notch of a child’s distal femur does not provide adequate exposure, thereby necessitating the removal of a substantial amount of unaffected bone to expose the lesion. In this study, we compared the functional outcomes, local recurrence, and surgical complications of treating a chondroblastoma of the distal femoral epiphysis by either an intercondylar or an epiphyseal approach. A total of 30 children with a chondroblastoma of the distal femur who had been treated by intraregional curettage and bone grafting were retrospectively reviewed. An intercondylar approach was used in 16 patients (group A) and an epiphyseal approach in 14 (group B). Limb function was assessed using the Musculoskeletal Tumor Society (MSTS) scoring system and Sailhan’s functional criteria.Aims
Methods
Orthopaedic surgeons are currently faced with an overwhelming number of choices surrounding total knee arthroplasty (TKA), not only with the latest technologies and prostheses, but also fundamental decisions on alignment philosophies. From ‘mechanical’ to ‘adjusted mechanical’ to ‘restricted kinematic’ to ‘unrestricted kinematic’ — and how constitutional alignment relates to these — there is potential for ambiguity when thinking about and discussing such concepts. This annotation summarizes the various alignment strategies currently employed in TKA. It provides a clear framework and consistent language that will assist surgeons to compare confidently and contrast the concepts, while also discussing the latest opinions about alignment in TKA. Finally, it provides suggestions for applying consistent nomenclature to future research, especially as we explore the implications of 3D alignment patterns on patient outcomes. Cite this article: