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ORTHOPEDICS AND TRAUMATOLOGY (150 journals)                     

Showing 1 - 152 of 152 Journals sorted alphabetically
Acta Orthopaedica     Open Access   (Followers: 32)
Advances in Orthopedics     Open Access   (Followers: 9)
American Journal of Orthodontics and Dentofacial Orthopedics     Hybrid Journal   (Followers: 9)
American Journal of Orthopedics     Partially Free   (Followers: 3)
Archives of Orthopaedic and Trauma Surgery     Hybrid Journal   (Followers: 9)
Archives of Osteoporosis     Hybrid Journal   (Followers: 1)
Arthritis und Rheuma     Hybrid Journal  
Arthroplasty Today     Open Access   (Followers: 1)
Australasian Musculoskeletal Medicine     Full-text available via subscription   (Followers: 5)
BMC Musculoskeletal Disorders     Open Access   (Followers: 29)
Bone & Joint 360     Full-text available via subscription   (Followers: 19)
Bone Research     Hybrid Journal   (Followers: 2)
Burns & Trauma     Open Access   (Followers: 11)
Cartilage     Hybrid Journal   (Followers: 5)
Case Reports in Orthopedic Research     Open Access  
Case Reports in Orthopedics     Open Access   (Followers: 6)
Chinese Journal of Traumatology     Open Access  
Cleft Palate-Craniofacial Journal     Hybrid Journal   (Followers: 8)
Clinical Medicine Insights : Arthritis and Musculoskeletal Disorders     Open Access   (Followers: 3)
Clinical Orthopaedics and Related Research     Hybrid Journal   (Followers: 78)
Clinical Trials in Orthopedic Disorders     Open Access   (Followers: 1)
Concussion     Open Access  
Craniomaxillofacial Trauma and Reconstruction     Hybrid Journal   (Followers: 1)
Current Orthopaedic Practice     Hybrid Journal   (Followers: 14)
Current Reviews in Musculoskeletal Medicine     Open Access   (Followers: 13)
Der Orthopäde     Hybrid Journal   (Followers: 6)
Die Wirbelsäule     Hybrid Journal  
Duke Orthopedic Journal     Open Access   (Followers: 4)
East African Orthopaedic Journal     Full-text available via subscription  
EFORT Open Reviews     Open Access   (Followers: 1)
Egyptian Orthopaedic Journal     Open Access   (Followers: 1)
EMC - Técnicas Quirúrgicas - Ortopedia y Traumatología     Full-text available via subscription  
EMC - Tecniche Chirurgiche - Chirurgia Ortopedica     Full-text available via subscription  
Ergonomics     Hybrid Journal   (Followers: 23)
European Journal of Orthopaedic Surgery & Traumatology     Hybrid Journal   (Followers: 9)
European Journal of Podiatry / Revista Europea de Podología     Open Access   (Followers: 1)
European Spine Journal     Hybrid Journal   (Followers: 24)
Foot & Ankle International     Hybrid Journal   (Followers: 10)
Foot & Ankle Orthopaedics     Open Access   (Followers: 3)
Gait & Posture     Hybrid Journal   (Followers: 17)
Geriatric Orthopaedic Surgery Rehabilitation     Open Access   (Followers: 5)
Global Spine Journal     Open Access   (Followers: 12)
Hip International     Hybrid Journal  
Indian Journal of Orthopaedics     Open Access   (Followers: 8)
Informationen aus Orthodontie & Kieferorthopädie     Hybrid Journal  
Injury     Hybrid Journal   (Followers: 20)
International Journal of Orthopaedic and Trauma Nursing     Hybrid Journal   (Followers: 11)
International Journal of Orthopaedic Surgery     Open Access   (Followers: 5)
International Journal of Orthopaedics     Open Access   (Followers: 2)
International Journal of Research in Orthopaedics     Open Access  
International Musculoskeletal Medicine     Hybrid Journal   (Followers: 7)
International Orthopaedics     Hybrid Journal   (Followers: 18)
JAAOS : Global Research & Reviews     Open Access   (Followers: 1)
JBJS Journal of Orthopaedics for Physician Assistants     Hybrid Journal  
JBJS Reviews     Full-text available via subscription   (Followers: 11)
JOR Spine     Open Access   (Followers: 3)
Journal de Traumatologie du Sport     Full-text available via subscription   (Followers: 2)
Journal für Mineralstoffwechsel & Muskuloskelettale Erkrankungen     Hybrid Journal  
Journal of Bone and Joint Diseases     Open Access   (Followers: 3)
Journal of Bone and Joint Infection     Open Access   (Followers: 1)
Journal of Brachial Plexus and Peripheral Nerve Injury     Open Access   (Followers: 4)
Journal of Cachexia, Sarcopenia and Muscle     Open Access   (Followers: 2)
Journal of Children's Orthopaedics     Open Access   (Followers: 10)
Journal of Clinical Orthopaedics and Trauma     Hybrid Journal   (Followers: 5)
Journal of Experimental Orthopaedics     Open Access   (Followers: 8)
Journal of Hand Surgery (European Volume)     Hybrid Journal   (Followers: 44)
Journal of Head Trauma Rehabilitation     Hybrid Journal   (Followers: 18)
Journal of Musculoskeletal Research     Hybrid Journal   (Followers: 9)
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie     Hybrid Journal  
Journal of Orthodontic Science     Open Access   (Followers: 2)
Journal of Orthopaedic & Sports Physical Therapy     Full-text available via subscription   (Followers: 72)
Journal of Orthopaedic Association of South Indian States     Open Access   (Followers: 5)
Journal of Orthopaedic Diseases and Traumatology     Open Access   (Followers: 3)
Journal of Orthopaedic Reports     Full-text available via subscription   (Followers: 12)
Journal of Orthopaedic Research     Hybrid Journal   (Followers: 29)
Journal of Orthopaedic Science     Hybrid Journal   (Followers: 4)
Journal of Orthopaedic Surgery     Open Access   (Followers: 1)
Journal of Orthopaedic Surgery and Research     Open Access   (Followers: 8)
Journal of Orthopaedic Translation     Open Access  
Journal of Orthopaedic Trauma     Hybrid Journal   (Followers: 15)
Journal of Orthopaedics     Full-text available via subscription   (Followers: 3)
Journal of Orthopaedics and Allied Sciences     Open Access   (Followers: 9)
Journal of Orthopaedics and Spine     Open Access   (Followers: 3)
Journal of Orthopaedics and Traumatology     Open Access   (Followers: 16)
Journal of Orthopaedics, Trauma and Rehabilitation     Open Access   (Followers: 6)
Journal of Orthopedics & Rheumatology     Open Access  
Journal of Orthopedics, Traumatology and Rehabilitation     Open Access   (Followers: 6)
Journal of Pediatric Orthopaedics     Hybrid Journal   (Followers: 15)
Journal of Prosthetics and Orthotics     Hybrid Journal   (Followers: 15)
Journal of Scleroderma and Related Disorders     Hybrid Journal  
Journal of the American Academy of Orthopaedic Surgeons     Hybrid Journal   (Followers: 12)
Journal of the American Podiatric Medical Association     Full-text available via subscription   (Followers: 8)
Journal of Traumatic Stress     Hybrid Journal   (Followers: 26)
Knee Surgery, Sports Traumatology, Arthroscopy     Hybrid Journal   (Followers: 27)
Multiple Sclerosis and Related Disorders     Hybrid Journal   (Followers: 9)
Musculoskeletal Care     Hybrid Journal   (Followers: 19)
Musculoskeletal Science and Practice     Hybrid Journal   (Followers: 3)
Nigerian Journal of Orthopaedics and Trauma     Open Access  
North American Spine Society Journal (NASSJ)     Open Access   (Followers: 3)
OA Orthopaedics     Open Access   (Followers: 7)
Obere Extremität     Hybrid Journal   (Followers: 1)
Open Journal of Orthopedics     Open Access   (Followers: 3)
Open Journal of Orthopedics and Rheumatology     Open Access  
Open Journal of Trauma     Open Access  
Open Orthopaedics Journal     Open Access  
Operative Orthopädie und Traumatologie     Hybrid Journal  
Operative Techniques in Orthopaedics     Full-text available via subscription   (Followers: 6)
Orthopädie & Rheuma     Full-text available via subscription  
Orthopädie und Unfallchirurgie up2date     Hybrid Journal  
Orthopaedic Journal of Sports Medicine     Open Access   (Followers: 14)
Orthopaedic Nursing     Hybrid Journal   (Followers: 11)
Orthopaedic Proceedings     Partially Free  
Orthopaedic Surgery     Open Access   (Followers: 1)
Orthopaedics & Traumatology: Surgery & Research     Full-text available via subscription   (Followers: 6)
Orthopaedics and Trauma     Full-text available via subscription   (Followers: 28)
Orthopedic Clinics of North America     Full-text available via subscription   (Followers: 5)
Orthopedic Research and Reviews     Open Access   (Followers: 6)
Orthopedic Reviews     Open Access   (Followers: 7)
Orthopedics     Full-text available via subscription   (Followers: 6)
Orthoplastic Surgery     Open Access  
Osteoarthritis and Cartilage     Full-text available via subscription   (Followers: 20)
Osteoarthritis and Cartilage Open     Open Access  
Osteologie     Hybrid Journal  
Osteoporosis and Sarcopenia     Open Access  
OTA International     Open Access  
Paediatric Orthopaedics and Related Sciences     Open Access   (Followers: 3)
Pain Management in General Practice     Full-text available via subscription   (Followers: 12)
Prosthetics and Orthotics International     Hybrid Journal   (Followers: 9)
Revista Brasileira de Ortopedia     Hybrid Journal  
Revista Chilena de Ortopedia y Traumatología / Chilean Journal of Orthopaedics and Traumatology     Open Access  
Revista Colombiana de Ortopedia y Traumatología     Full-text available via subscription  
Revista Cubana de Ortopedia y Traumatologí­a     Open Access  
Revista de la Asociación Argentina de Ortopedia y Traumatología     Open Access  
Revista Española de Cirugía Ortopédica y Traumatología     Full-text available via subscription   (Followers: 1)
Revista Portuguesa de Ortopedia e Traumatologia     Open Access  
Revue de Chirurgie Orthopédique et Traumatologique     Full-text available via subscription   (Followers: 3)
Romanian Journal of Orthopaedic Surgery and Traumatology     Open Access  
SA Orthopaedic Journal     Open Access   (Followers: 2)
SICOT-J     Open Access   (Followers: 1)
Spine     Hybrid Journal   (Followers: 73)
Spine Journal     Hybrid Journal   (Followers: 26)
Sport-Orthopädie - Sport-Traumatologie - Sports Orthopaedics and Traumatology     Full-text available via subscription   (Followers: 3)
Strategies in Trauma and Limb Reconstruction     Open Access   (Followers: 1)
Techniques in Orthopaedics     Hybrid Journal   (Followers: 6)
Therapeutic Advances in Musculoskeletal Disease     Hybrid Journal   (Followers: 5)
Trauma     Hybrid Journal   (Followers: 5)
Trauma (Travma)     Open Access  
Trauma und Berufskrankheit     Hybrid Journal  
Traumatology     Full-text available via subscription   (Followers: 1)
Traumatology and Orthopedics of Russia     Open Access  
Zeitschrift für Orthopädie und Unfallchirurgie     Hybrid Journal   (Followers: 2)
Ортопедия, травматология и протезирование     Open Access  

           

Similar Journals
Journal Cover
Knee Surgery, Sports Traumatology, Arthroscopy
Journal Prestige (SJR): 1.845
Citation Impact (citeScore): 3
Number of Followers: 27  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1433-7347 - ISSN (Online) 0942-2056
Published by Springer-Verlag Homepage  [2469 journals]
  • Correction to: Acetabular retroversion does not affect outcome in primary
           hip arthroscopy for femoroacetabular impingement

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      PubDate: 2022-10-01
       
  • Lower anatomical femoral ACL tunnel can be created in the large volume of
           femoral intercondylar notch

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      Abstract: Purpose The purpose of this study was to investigate the correlation between femoral intercondylar notch volume and the characteristics of femoral tunnels in anatomical single bundle anterior cruciate ligament (ACL) reconstruction. Methods Fifty-one subjects (24 male and 27 female: median age 27: range 15–49), were included in this study. Anatomical single bundle ACL reconstruction was performed in all subjects using a trans-portal technique. Femoral tunnel length was measured intra-operatively. Three-dimensional computed tomography (3D-CT) was taken at pre and post-surgery. The intercondylar notch volume was calculated with a truncated-pyramid shape simulation using the pre-operative 3D-CT image. In the post-operative 3D-CT, the modified quadrant method was used to measure femoral ACL tunnel placement. Results Femoral tunnel placement was 47.6 ± 10.5% in the high-low (proximal–distal) direction, and 22.6 ± 5.4% in the shallow-deep (anterior–posterior) direction. Femoral tunnel length was 35.3 ± 4.4 cm. Femoral intercondylar notch volume was 8.6 ± 2.1cm3. A significant correlation was found between femoral intercondylar notch volume and high-low (proximal–distal) femoral tunnel placement (Pearson’s coefficient correlation: 0.469, p = 0.003). Conclusion Femoral ACL tunnel placement at a significantly lower level was found in knees with large femoral intercondylar notch volume in the trans-portal technique. For the clinical relevance, although the sample size of this study was limited, surgeons can create femoral ACL tunnel low (distal) in the notch where close to the anatomical ACL footprint in the knees with large femoral intercondylar notch volume. Level of evidence III.
      PubDate: 2022-10-01
       
  • A high level of knee laxity after anterior cruciate ligament
           reconstruction results in high revision rates

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      Abstract: Purpose The literature indicates a lack of consensus on the correlation between knee laxity after anterior cruciate ligament reconstruction (ACLR) and subjective clinical outcomes and the need for revision surgery. Therefore, using high-volume registry data, this study aimed to describe the relationship between objective knee laxity after ACLR and subjective symptom and functional assessments and the need for revision surgery. The hypothesis was that greater postoperative knee laxity would correlate with inferior patient-reported outcomes and a higher risk for revision surgery. Methods In this study, 17,114 patients in the Danish knee ligament reconstruction registry were placed into three groups on the basis of objective side-to-side differences in sagittal laxity one year after surgery: group A (≤ 2 mm), Group B (3–5 mm) and Group C (> 5 mm). The main outcome measure was revision rate within 2 years of primary surgery, further outcome measures were the knee injury and osteoarthritis outcome score (KOOS) as well as Tegner activity score. Results The study found the risk for revision surgery was more than five times higher for Group C [hazard ratio (HR) = 5.51] than for Group A. The KOOS knee-related Quality of Life (QoL) sub-score exhibited lower values when comparing Groups B or C to Group A. In addition, the KOOS Function in Sport and Recreation (Sport/Rec) sub-score yielded lower values for groups B and C in comparison with Group A. Conclusion These results indicate that increased post-operative sagittal laxity is correlated with an increased risk for revision surgery and might correlate with poorer knee-related QoL, as well as a decreased function in sports. The clinical relevance of the present study is that high knee laxity at 1-year follow-up is a predictor of the risk of revision surgery. Level of evidence III.
      PubDate: 2022-10-01
       
  • The incidence of complications after derotational femoral and/or tibial
           osteotomies in patellofemoral disorders in adolescents and active young
           patients: a systematic review with meta-analysis

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      Abstract: Purpose To quantify the risk of perioperative and postoperative complications of derotational femoral and/or tibial osteotomies in patellofemoral disorders (anterior knee pain and patellar instability) in adolescents and active young patients. Methods MEDLINE, EMBASE, Cochrane and Scopus databases were used to identify studies published from database inception and June 30, 2021. Meta-analysis was performed to pool the rates of complications related to femur and tibia osteotomies. Values of proportion of complications were expressed as proportions and 95% confidence intervals (CI) and then transformed using a Freeman Tukey double arcsine transformation. Meta-regression was used to explore factors that potentially may influence on heterogeneity such as year of publication, quality of the included studies and site of the osteotomy. Results The 22 studies identified included a total of 648 derotational osteotomies in 494 patients. Studies consisted of 20 case series (non-comparative) and 2 comparative observational non-randomized cohorts. Tibial osteotomies showed higher risk of complications than femoral osteotomies (random pooled prevalence 9%; 95% CI 4–15% versus 1%; 95% CI 0–5%, respectively, p < 0.01). The meta-regression analysis of the articles showed that the only parameters responsible of the variance in number of complications were the osteotomy site. Conclusions Derotational femoral and/or tibial osteotomy is a safe surgical procedure in the treatment of patellofemoral disorders (anterior knee pain and patellar instability) in adolescents and active young people. Level of evidence IV.
      PubDate: 2022-10-01
       
  • Acute and subacute anterior cruciate ligament reconstructions are
           associated with a higher risk of revision and reoperation

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      Abstract: Purpose (1) Report concomitant cartilage and meniscal injury at the time of anterior cruciate ligament reconstruction (ACLR), (2) evaluate the risk of aseptic revision ACLR during follow-up, and (3) evaluate the risk of aseptic ipsilateral reoperation during follow-up. Methods Using a United States integrated healthcare system’s ACLR registry, patients who underwent primary isolated ACLR were identified (2010–2018). Multivariable Cox proportional-hazards regression was used to evaluate the risk of aseptic revision, with a secondary outcome evaluating ipsilateral aseptic reoperation. Outcomes were evaluated by time from injury to ACLR: acute (< 3 weeks), subacute (3 weeks–3 months), delayed (3–9 months), and chronic (≥ 9 months). Results The final sample included 270 acute (< 3 weeks), 5971 subacute (3 weeks–3 months), 5959 delayed (3–9 months), and 3595 chronic (≥ 9 months) ACLR. Medial meniscus [55.4% (1990/3595 chronic) vs 38.9% (105/270 acute)] and chondral injuries [40.0% (1437/3595 chronic) vs 24.8% (67/270 acute)] at the time of ACLR were more common in the chronic versus acute groups. The crude 6-year revision rate was 12.9% for acute ACLR, 7.0% for subacute, 5.1% for delayed, and 4.4% for chronic ACLR; reoperation rates a 6-year follow-up was 15.0% for acute ACLR, 9.6% for subacute, 6.4% for delayed, and 8.1% for chronic ACLR. After adjustment for covariates, acute and subacute ACLR had higher risks for aseptic revision (acute HR 1.70, 95% CI 1.07–2.72, p = 0.026; subacute HR 1.25, 95% CI 1.01–1.55, p = 0.040) and aseptic reoperation (acute HR 2.04, 95% CI 1.43–2.91, p < 0.001; subacute HR 1.31, 95% CI 1.11–1.54, p = 0.002) when compared to chronic ACLR. Conclusions In this cohort study, while more meniscal and chondral injuries were reported for ACLR performed ≥ 9 months after the date of injury, a lower risk of revision and reoperation was observed following chronic ACLR relative to patients undergoing surgery in acute or subacute fashions. Level of evidence III.
      PubDate: 2022-10-01
       
  • Different injury patterns exist among patients undergoing operative
           treatment of isolated PCL, combined PCL/ACL, and isolated ACL injuries: a
           study from the Swedish National Knee Ligament Registry

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      Abstract: Purpose To compare demographic characteristics and concomitant injury patterns in patients undergoing primary isolated posterior cruciate ligament reconstruction (PCL-R) and combined posterior cruciate ligament (PCL) and anterior cruciate ligament (ACL) reconstruction (PCL-R/ACL-R) with isolated ACL reconstruction (ACL-R) as a reference using data from the Swedish National Knee Ligament Registry (SNKLR). Methods This cohort study based on the SNKLR comprised patients undergoing either PCL-R, ACL-R, or combined PCL-R/ACL-R between January 1, 2005 and December 31, 2019 in Sweden. Demographic and surgery-related data with regards to injury mechanism, concomitant intraarticular lesions and their treatment, neurovascular damage, and concomitant ligamentous injuries were extracted. Exclusion criteria included concomitant fractures of the femur, fibula, patella or tibia, and quadriceps or patellar tendon injury. Results A total of 45,564 patients were included in this study. Isolated PCL-R, combined PCL-R/ACL-R, and isolated ACL-R were performed in 192 (0.4%), 203 (0.5%) and 45,169 (99.1%) patients, respectively. Sports were identified as the cause of 64% of PCL-Rs, 54% of PCL-R/ACL-Rs, and 89% of ACL-Rs, while a traffic-related mechanism was identified in 20% of PCL-Rs, 27% of PCL-R/ACL-Rs and 2% of ACL-Rs. Meniscus injury prevalence was 45% in ACL-Rs, 31% in PCL-R/ACL-Rs and 16% in isolated PCL-Rs (p < 0.001). Cartilage injuries were more common in PCL-R (37%) and PCL-R/ACL-R patients (40%) compared to ACL-R patients (26%, p < 0.001). Concomitant knee ligament injury was identified in 28–44% of PCL-R/ACL-R patients. Neurovascular injuries were present in 9% of PCL-R/ACL-Rs, 1% of PCL-Rs, and 0.3% of ACL-Rs (p < 0.001). Conclusion Differences in injury mechanisms among patient groups confirm that operatively treated PCL tears are frequently caused by both traffic and sports. Cartilage and ligament injuries were more frequent in patients with PCL-R compared to ACL-R. Consequently, combined PCL and ACL tears should raise suspicion for concomitant knee lesions with clinical relevance during the operative treatment of these complex injuries. Level of evidence III.
      PubDate: 2022-10-01
       
  • The tibial tubercle–posterior cruciate ligament (TT–PCL) distance does
           not truly reflect the lateralization of the tibial tubercle

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      Abstract: Purpose The role of the tibial tubercle–posterior cruciate ligament (TT–PCL) and tibial tubercle–trochlear groove (TT–TG) in recurrent patellar instability (RPI) remains unclear. This study aims to confirm the validity of the TT–TG and TT–PCL in predicting RPI and to verify whether the TT–PCL can truly reflect the lateralization of the tibial tubercle. Methods A total of 50 patients with RPI and 50 controls were recruited and underwent magnetic resonance imaging examinations. The TT–TG, TT–PCL, and tibial tubercle lateralization (TTL) were measured independently by two authors in a blinded and randomized fashion. T-test was used for parametric variances and the Mann–Whitney U and Chi-square tests were used for non-parametric variances. Pearson’s product moment correlation coefficients were calculated to determine correlations between the defined measurements. The intraclass correlation coefficient was used to assess the reliability of the measurements. Results All defined measurements showed excellent intra- and inter-observer reliability. The TT–TG distance, TT–PCL distance, and TTL were significantly greater in the PI group than in the control group. The AUC was highest for the TT–TG distance compared with that for the TT–PCL distance, and TTL were 0.798, 0.764, and 0.769, with the calculated cut-off value of 12.5 mm, 16.5 mm, and 66.1 percentages. There was a moderate correlation (r = 0.595) between the TT–TG distance and TTL, and a weak correlation (r = 0.430) between the TT–PCL distance and TTL. Conclusion Both the TT–TG distance and TT–PCL distance can be measured with excellent reliability on magnetic resonance imaging. The TT–TG distance, rather than the TT–PCL distance, has a better performance in predicting RPI. Most interestingly, the TT–PCL distance cannot reflect the real lateralization of TT. This study provides new information to evaluate TTL in patients with RPI. Level of evidence III.
      PubDate: 2022-10-01
       
  • Combined femoral–obturator–sciatic nerve block has superior
           postoperative pain score and earlier ambulation as compared to spinal
           anaesthesia for arthroscopic anterior cruciate ligament reconstruction

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      Abstract: Purpose Peripheral nerve blocks can be a suitable alternative to central neuraxial blockage, as the sole anaesthetic agent for better early postoperative outcomes, decreased hospital stay and earlier mobilisation after anterior cruciate ligament reconstruction (ACLR) surgery. The purpose of this study was to compare consciousness during the procedure, pain during early postoperative period (< 7 days), and perioperative outcomes following ACLR using combined sciatic, femoral, and obturator nerve blocks compared to the spinal anaesthesia. Methods This was a prospective case–control study including patients between 18 and 55 years of age, with anterior cruciate ligament (ACL) injury confirmed clinically and radiologically and undergoing ACLR. Patients were allocated in the two groups alternatively, group 1 included patients who received combined nerve blocks, and group 2 included patients who received spinal anaesthesia for the surgery. The sensory effect, motor effect, adequacy of anaesthesia, perioperative analgesic use, duration of stay, postoperative pain (visual analogue scale 0–10 cm) and functional outcomes were noted. Results There were 60 patients in each group. A total of seven patients in group 1 (11%) and two patients in group 2 (3%) needed conversion to general anaesthesia (n.s.). In group 1, out of 53 patients who underwent surgery, 26 patients had no perception of surgery in the joint, 17 patients had perception of manipulation of the knee joint, 4 patients had sense of touch, and 6 patients had sensation of pain in the knee (VAS scale less than 3). In group 2, out of 58 patients, 42 patients had no perception of surgery, 12 had a perception of manipulation of the knee joint, 2 had sense of touch, and 2 had sensation of pain in the knee. Blockage of sensory effect was significantly better in group 2 (p = 0.0001). However, the motor effect was comparable between the two groups (n.s.). Group 1 had significantly better pain scores 6, 12, and 18 h after the surgery. Moreover, patients in group 1 also had faster ambulation (mean difference of 5.5 h, p = 0.0001) and reduced hospital stay (mean difference of 8.4 h, p = 0.0001). Conclusion Combined sciatic, femoral, and adductor canal block is an effective sole anaesthetic modality for ACLR. The sensory effect was inferior when compared to spinal anaesthesia but sufficient for the procedure without the need for supplementation with any other anaesthetic modality. Patients receiving this combined nerve block had lesser early postoperative pain scores, earlier ambulation, and shorter hospital stay as compared to the spinal anaesthesia. Level of evidence Level 3.
      PubDate: 2022-10-01
       
  • Excellent clinical and radiological outcomes after both open flake
           refixation and autologous chondrocyte implantation following acute patella
           dislocation and concomitant flake fractures

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      Abstract: Purpose To investigate clinical and magnetic resonance (MR) imaging results of patients undergoing patella stabilization with either open flake refixation (oFR) or autologous chondrocyte implantation (ACI) and concomitant soft tissue patella stabilization after sustaining primary, acute patella dislocation with confirmed chondral and/or osteochondral flake fractures. It was hypothesized that refixation will lead to better results than ACI at mid-term follow-up. Methods A retrospective chart review was conducted to identify all patients undergoing oFR or ACI after sustaining (osteo-)chondral flake fractures and concomitant soft tissue patella stabilization following primary, acute patella dislocation between 01/2012 and 09/2018 at the author’s institution. Patients were excluded if they were aged < 14 years or > 30 and had previous knee surgeries at the index knee. Clinical outcomes were assessed using the Tegner activity score, Kujala score, subjective IKDC score, and the KOOS score at a minimum follow-up of 24 months postoperatively. MR images were assessed using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 knee score. Thirty patients were included in the study, with 16 patients assorted to the oFR group and 14 patients to the ACI group (Follow-up 81%). Results Demographic data did not show significant group differences (oFR: 6 females, 10 males; age 26.9 ± 5.6 years, FU: 57 months (27–97 months); ACI: 9 females, 5 males; age 25.5 ± 4.9 years, FU: 51 months (29–91 months); n.s.). Defect location was similar in both groups (oFR: 12 × patella/4 × lateral femoral condyle; ACI: 12/2; n.s.). Both groups showed excellent clinical outcomes, with no statistically significant difference between both the groups (oFR group vs. ACI group: Tegner: 5.1 ± 1.8 vs. 5.1 ± 1.4; Kujala: 86.1 ± 12.6 vs. 84.9 ± 9.1; IKDC: 83.8 ± 15.0 vs. 83.6 ± 11.3; KOOS: 83.3 ± 14.0 vs. 83.6 ± 12.0; n.s.). One patient in each group suffered a patella re-dislocation and needed revision surgery. The MOCART 2.0 score showed good results for the oFR group (68.2 ± 11.1) and the ACI group (61.1 ± 16.9) while no significant differences were noted between both the groups. The inter-rater reliability was excellent (0.847). Conclusion Open refixation of (osteo-)chondral fragments in patients after sustaining acute patella dislocation with (osteo)-chondral flake fractures led to good clinical and radiological results at a minimum follow of 24 months, showing that it is a good surgical option in the treatment algorithm. However, if open refixation is not possible, ACI may be an excellent fallback option in these younger patients with equally good clinical and radiological outcomes, but requiring a second minimally invasive surgery. Level of evidence III.
      PubDate: 2022-10-01
       
  • Picking apart p values: common problems and points of confusion

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      Abstract: Abstract Due to its frequent misuse, the p value has become a point of contention in the research community. In this editorial, we seek to clarify some of the common misconceptions about p values and the hazardous implications associated with misunderstanding this commonly used statistical concept. This article will discuss issues related to p value interpretation in addition to problems such as p-hacking and statistical fragility; we will also offer some thoughts on addressing these issues. The aim of this editorial is to provide clarity around the concept of statistical significance for those attempting to increase their statistical literacy in Orthopedic research.
      PubDate: 2022-10-01
       
  • Medial patellofemoral ligament reconstruction is superior to active
           rehabilitation in protecting against further patella dislocations

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      Abstract: Purpose Isolated reconstruction of the medial patellofemoral ligament (MPFL-R) has become the predominant stabilizing procedure in the treatment of recurrent lateral patellar dislocation (LPD). To minimize the risk of re-dislocations, isolated MPFL-R is recommended in patients with no significant trochlea dysplasia and tibial tuberosity trochlear groove distance < 20 mm on computed tomography (CT). Incidentally, these criteria are the same that are used to identify first time LPD patients where conservative treatment is recommended. The purpose of this study was therefore to compare MPFL-R with active rehabilitation for patients with recurrent LPD (RLPD) in absence of the above mentioned underlying anatomical high-risk factors for further patellar dislocations. Methods RLPD-patients aged 12–30 without underlying anatomical high-risk factors for further LPD were randomized into treatment either with isolated MPFL-R or active rehabilitation provided and instructed by a physiotherapist. All patients underwent diagnostic arthroscopy for concomitant problems. The main outcome measure was persistent patellar instability at 12 months. Knee function at baseline and 12 months was asses using the following patient reported outcomes measures (PROMS); KOOS, Kujala, Cincinnati knee rating, Lysholm score and Noyes sports activity rating scale. Results Between 2010 and 2019, 61 patients were included in the study (MPFL-R, N = 30, Controls, N = 31). Persistent patellar instability at 12 months was reported by 13 (41.9%) controls, versus 2 (6.7%) in the MPFL-group (RR 6.3 (95% CI 1.5–25.5). No statistically significant differences in activity level were found between the MPFL-group and the Controls at neither baseline nor follow up. The patients with persistent instability at 12 months did not score significantly lower on any of the PROMs compared to their stable peers, regardless of study group. Conclusion Patients with recurrent patellar dislocations have a six-fold increased risk of persistent patellar instability if treated with active rehabilitation alone, compared to MPFL-R in combination with active rehabilitation, even in the absence of significant anatomical risk factors. Active rehabilitation of the knee without MPFL-R improves patient reported knee function after one year, but does not protect against persistent patellar instability. Level of evidence 1.
      PubDate: 2022-10-01
       
  • Magnetic resonance imaging overestimates patellar height compared with
           radiographs

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      Abstract: Purpose To evaluate the inter-observer and inter-method reliability for patellar height measurements between conventional radiographs (CR) and magnetic resonance imaging (MRI) using one or two slices. Methods This was a reliability study, with 60 patients divided in two groups: 30 patients with patellar instability (patella group) and 30 patients with anterior cruciate ligament or meniscus injury (control group). CR and MRI were evaluated by two independent observers. Insall–Salvati index (IS) and Caton–Deschamps index (CD) were measured using three different methods: CR, one-slice MRI or two-slice MRI. Intra-class correlation coefficients (ICC) were calculated for inter-observer reliability and inter-method reliability. Bland–Altman agreement was also calculated. Results The inter-observer reliability was very good for the IS with ICCs of 0.93, 0.84 and 0.82, for the CR, one-slice MRI and two-slice MRI, respectively. Similarly, for the CD the ICCs were good, 0.76, 0.80 and 0.75 for the CR, one-slice MRI and two-slice MRI, respectively. No differences were found between the patella and the control group. The inter-method analysis results were: ICCs for IS (0.83, 0.86, 0.93) and CD (0.72, 0.82, 0.83), for the comparisons of CR/one-slice MR, CR/two-slice MRI and one-slice MRI/two-slice MRI, respectively. The Bland–Altman mean differences showed an 8% and a 7% increase on IS values with one-slice MRI and two-slice MRI compared to CR results, while the increase was of 9% and 1% in CD for the respective comparisons with CR. Conclusion MRI can overestimate patellar height compared to CR, as much as an 8% increase in Insall–Salvati values when using one- or two-slice MRI measurements, and up to a 9% increase in Caton–Deschamps value when using the one-slice MRI method. It is recommended to use the CR as the preferred method when measuring patellar height. Level of evidence III.
      PubDate: 2022-10-01
       
  • High recall bias in retrospective assessment of the pediatric
           International Knee Documentation Committee Questionnaire (Pedi-IKDC) in
           children with knee pathologies

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      Abstract: Purpose The increasing incidence of knee injuries among children is well known by sports physicians. Papers dealing with this topic have often collected patient-reported outcomes measures (PROMs) in a retrospective manner; this limitation could lead to a misinterpretation of the results, because pediatric patients might not remember their preoperative conditions adequately. This study aims to evaluate the reliability and the reproducibility of the IKDC pediatric score when administered retrospectively at a 12-month follow-up. Methods From September 2018 and June 2019, all patients aged 7–18 scheduled for surgery due to different knee pathologies in a single center were considered eligible. Parents were contacted by phone for consent. An open-source platform was implemented to collect the responses: two surveys were created (Q1, Q2). They included general information and the Pedi-IKDC score. Q1 was completed prospectively, while Q2 was completed 12 months after surgery. The two questionnaires were identical, and patients were carefully advised to complete Q2 recalling their health status before surgery. ICC and the concordance correlation coefficient (ρc) were used to assess the reproducibility between the prospective and recalled scores. Results Sixty-six patients responded to Q1 and Q2, and the mean age was 12.9 ± 2.2 years at Q1 and 14.1 ± 2.2 years at Q2. The mean time between Q1 and Q2 was 14.1 ± 2.1 months. Between prospective-IKDC and recall-IKDC, the ICC coefficient was "poor” at 0.32 (CI 0.09 to 0.5) and the ρc was “poor” at 0.4 (CI 0.29 to 0.51). Mean prospective-IKDC was 76.8 ± 23.52 mean recalled-IKDC was 60.4 ± 11.5 (P < 0.0001), while mean difference was -16.3 ± 2.09. Simple linear regression models showed that Δ-IKDC is independently associated with age at Q1 (R2 = 0.2676; P0.0001)  and prospective-IKDC (R2 = 0.653; P < 0.0001). Conclusions Retrospective collection of the Pedi-IKDC score is not reliable and has high recall bias. This should be avoided in children with knee conditions. Level of evidence III.
      PubDate: 2022-10-01
       
  • Few young athletes meet newly derived age- and activity-relevant
           functional recovery targets after ACL reconstruction

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      Abstract: Purpose National registry data have established Knee injury and Osteoarthritis Outcome Score (KOOS) functional recovery target values for adults after anterior cruciate ligament (ACL) reconstruction. However, the specificity of these target values for young athletes after ACL reconstruction is unclear. The purpose of this analysis was to (1) derive age- and activity-relevant KOOS functional recovery target values from uninjured young athlete data and (2) determine clinical measures at the time of RTS clearance associated with meeting the newly-derived functional recovery target values in young athletes following ACLR. Methods Two hundred and twenty-two young athletes (56 uninjured controls, 17.2 ± 2.4 years, 73% female; 166 after ACL reconstruction, 16.9 ± 2.2 years, 68% female) were included in this cross-sectional analysis from a larger cohort study. Uninjured control participants completed the KOOS, and functional recovery target values were defined as the lower bound of the 95% confidence interval for KOOS subscales. ACL reconstruction participants completed testing within 4 weeks of return-to-sport clearance, including the KOOS, single-leg hop tests, and isometric quadriceps strength. In ACL reconstruction participants, logistic regression was used to determine predictors of meeting all KOOS functional recovery target values (primary outcome) among demographic/injury, hop, and strength data (α ≤ 0.05). Results KOOS functional recovery target values for each subscale from uninjured athlete data were: Pain ≥ 94, Symptoms ≥ 92, Activities of Daily Living ≥ 97, Sport ≥ 92, and Quality-of-Life ≥ 92. At the time of return-to-sport clearance, ACL reconstruction participants met the KOOS functional recovery targets in the following proportions: Pain, 63%; Symptoms, 42%; Activities of Daily Living, 80%; Sport, 45%; Quality-of-Life, 24%; overall functional recovery (met all subscale targets), 17%. In ACL reconstruction participants, significant predictors of overall functional recovery (primary outcome) were: younger age, hamstring graft, pediatric ACL reconstruction, quadriceps strength limb-symmetry index > 90%, single-hop limb-symmetry index > 90%, and crossover-hop limb-symmetry index > 90%. Conclusions KOOS functional recovery target values derived from uninjured young athletes were higher than those previously reported. Small proportions of young athletes following recent RTS clearance after ACLR met these newly-derived functional recovery target values, and factors associated with meeting functional recovery target values included younger age, hamstring autograft and pediatric ACLR, and having > 90% LSI for quadriceps strength and single-leg hop tests. Level of evidence I.
      PubDate: 2022-10-01
       
  • Acetabular retroversion does not affect outcome in primary hip arthroscopy
           for femoroacetabular impingement

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      Abstract: Purpose The surgical treatment of femoral-acetabular impingement syndrome (FAIS) in patients with acetabular retroversion (AR) is arthroscopical or by a reverse periacetabular osteotomy (PAO). The purpose of the present study was to investigate the results after arthroscopic treatment of FAIS in patients with and without radiographic signs of AR in a large, prospective cohort from the Danish Hip Arthroscopy Registry (DHAR). The hypothesis was there is no difference in clinical outcome between the two groups. Methods Data on 4914 hip arthroscopies performed during 2012–2019 were obtained from DHAR. Patients with radiographic signs of osteoarthritis (Tönnis > 1), hip dysplasia (CEA < 25°), other hip pathologies or previous hip surgery were excluded. The clinical outcomes for patients with AR [defined by a positive posterior wall sign (PWS) in combination with a positive Ischial Spine Sign (ISS)] and patients without AR (no PWS, no ISS) were analyzed 1 and 2 years after surgery. The primary outcomes were the six domains of the Copenhagen Hip and Groin Outcome score (HAGOS), while secondary outcomes were the Hip Sports Activity Scale (HSAS), a visual analogue pain scale (VAS) and a numeric rating scale (NRS) for pain. Results A total of 3135 hip arthroscopies were included, of which 339 had AR, 1876 did not, and 920 presented one of the two signs (PWS and ISS). There were no statistically significant differences 1 and 2 years after surgery (n.s.) between patients with and without AR in HAGOS domain scores, HSAS, VAS, or NRS. Both groups showed improvement at both follow-ups. The two groups did not differ in relation to intraoperative findings and the procedures they have had. Conclusion The outcome 1 and 2 years after arthroscopic treatment of FAIS is not different for patients with and without AR. Level of evidence III.
      PubDate: 2022-10-01
       
  • Integration of polyurethane meniscus scaffold during ACL revision is not
           reliable at 5 years despite favourable clinical outcome

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      Abstract: Purpose The aim of this study was to evaluate the clinical outcome at 5-year follow-up of a one-step procedure combining anterior cruciate ligament (ACL) reconstruction and partial meniscus replacement using a polyurethane scaffold for the treatment of symptomatic patients with previously failed ACL reconstruction and partial medial meniscectomy. Moreover, the implanted scaffolds have been evaluated by MRI protocol in terms of morphology, volume, and signal intensity. Methods Twenty patients with symptomatic knee laxity after failed ACL reconstruction and partial medial meniscectomy underwent ACL revision combined with polyurethane-based meniscal scaffold implant. Clinical assessment at 2- and 5-year follow-ups included VAS, Tegner Activity Score, International Knee Documentation Committee (IKDC), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Lysholm Score. MRI evaluation of the scaffold was performed according to the Genovese scale with quantification of the scaffold’s volume at 1- and 5-year follow-ups. Results All scores revealed clinical improvement as compared with the preoperative values at the 2- and 5-year follow-ups. However, a slight, but significant reduction of scores was observed between 2 and 5 years. Concerning the MRI assessment, a significant reduction of the scaffold’s volume was observed between 1 and 5 years. Genovese Morphology classification at 5 years included two complete resorptions (Type 3) and all the remaining patients had irregular morphology (Type 2). With regard to the Genovese Signal at the 5-year follow-up, three were classified as markedly hyperintense (Type 1), 15 as slightly hyperintense (Type 2), and two as isointense (Type 1). Conclusion Simultaneous ACL reconstruction and partial meniscus replacement using a polyurethane scaffold provides favourable clinical outcomes in the treatment of symptomatic patients with previously failed ACL reconstruction and partial medial meniscectomy at 5 years. However, MRI evaluation suggests that integration of the scaffold is not consistent. Level of evidence Level IV.
      PubDate: 2022-10-01
       
  • Time, graft, sex, geographic location, and isokinetic speed influence the
           degree of quadriceps weakness after anterior cruciate ligament
           reconstruction: a systematic review and meta-analysis

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      Abstract: Purpose Although quadriceps weakness after ACL reconstruction (ACLR) is well documented, the magnitude of reported weakness varies considerably. Such variation raises the possibility that certain patients may be more susceptible to quadriceps weakness after ACLR. This meta-analysis identified factors explaining between-study variability in quadriceps weakness post-ACLR. Methods Studies between 2010 and 2020 were screened for the following criteria: human subjects, unilateral ACLR, and strength reported both for the ACLR leg and the uninjured or healthy-control leg. 122 studies met the criteria, resulting in 303 and 152 Cohen’s d effect sizes (ESs) comparing ACLR legs to uninjured legs (a total of 4135 ACLR subjects) and to healthy controls (a total of 1,507 ACLR subjects vs. 1-193 healthy controls), respectively. Factors (time, graft, sex, activity, mass/height, geographic area, concomitant injury, and type of strength testing) that may affect study ES were examined. Results Meta-regressions indicated an association between time post-ACLR and study ESs (P < 0.001) and predicted full recovery (ES = 0) to occur at 54–59 months post-ACLR. When compared to uninjured legs, patients with patellar tendon autografts had greater deficits than studies using hamstring tendon autografts (P = 0.023). When compared to uninjured legs, studies including only males reported greater deficits than studies combining males and females (P = 0.045); whereas when compared to healthy controls, studies combining males and females reported greater deficits than studies with males (P = 0.013). When compared to controls, studies from USA reported greater deficits than studies from Europe (P = 0.003). Increased isokinetic-testing speed was associated with smaller deficits (P ≤ 0.025). Less than 25% of patients achieved a between-limb symmetry in quadriceps strength > 90% between 6 and 12 months post-ACLR. Conclusion Time post-surgery, graft, sex, geographic location, and isokinetic speed influenced the magnitude of post-ACLR quadriceps weakness. Patients with patellar tendon autografts demonstrated greater between-limb asymmetry in quadriceps strength, while female strength deficits were underestimated to a greater extent. A slower isokinetic speed provided a more sensitive assessment of quadriceps strength post-ACLR. The overwhelming majority of patients were returning to sport with significantly impaired quadriceps strength. Level of evidence III.
      PubDate: 2022-10-01
       
  • Transosseous repair with a cortical implant for greater tubercle
           cyst-related rotator cuff tear results in good clinical outcomes, but
           significant implant migration

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      Abstract: Purpose To evaluate whether an arthroscopic transosseous technique (ATO) with cortical implants is effective for rotator cuff tear (RCT) repair in patients with cysts of the greater tuberosity (GTC). Methods Patients treated with the ATO technique between January 2013 and October 2017 were evaluated. Inclusion criteria were patients treated for both cyst-related and non-cyst-related RCTs and patients with a moderate-sized tear (1–3 cm) according to the DeOrio and Cofield classification. A total of 39 patients were separated into two groups: Group 1 (n = 16) patients with cyst-associated RCT, and Group 2 (n = 23) patients with no cyst. Implant pull-out and migration were evaluated radiologically on standard antero-posterior shoulder radiographs and rotator cuff re-tear was assessed on magnetic resonance images at the final follow-up examination. Group 1 patients were separated into two subgroups according to cyst size (cyst < 5 mm and cyst ≥ 5 mm) and subgroup analysis was performed. Clinical assessment was performed using a visual analog scale, the Constant score and Oxford shoulder score. Results The mean follow-up time was 33.7 ± 11.7 months. The mean cyst size was 5.4 ± 1.5 mm. There was no significant difference in re-tear rates between the cystic and non-cystic groups. The mean implant migration distance was 3.0 ± 2.2 mm in patients with a RCT -related cyst and 0.7 ± 0.8 mm in those without a cyst. A statistically significant difference was found between the groups (p = 0.002). There was no statistically significant difference between the groups in respect of clinical scores. No implant failure was observed. Conclusion The ATO method performed with a cortical implant in RCTs resulted in satisfactory recovery and clinical outcomes in the short to medium term with low failure rates. While no implant failures were observed, implant migration was associated with cyst presence. Therefore, judicious use is advocated in the choice of transosseous fixation for cyst-related RCTs and patients should be informed of the possibility of implant migration. Level of evidence III.
      PubDate: 2022-10-01
       
  • Autologous chondrocyte implantation combined with anterior cruciate
           ligament reconstruction: similar short-term results in comparison with
           isolated cartilage repair in ligament intact joints

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      Abstract: Purpose Both acute ruptures of the anterior cruciate ligament (ACL) as well as chronic ACL insufficiency show a high association with focal cartilage defects of the knee. However, the results after combined ACL reconstruction and cartilage repair are not well investigated. The aim of the present study was to investigate the short-term outcomes after autologous chondrocyte implantation (ACI) in combination with ACL reconstruction and to compare the results with patients who underwent isolated ACI in ligament intact knees. Methods All patients who were registered in the German Cartilage Registry with ACI for focal cartilage defects in the knee joint in combination with ACL reconstruction and who completed the 24 month follow-up were included in the study group. A matched-pair procedure according to gender, defect location, defect size, and age was used to create a control group of patients with isolated ACI in ACL intact joints. The Knee Injury and Osteoarthritis Outcome Score (KOOS) and the numeric analog scale for pain (NAS) were used to assess the preoperative state as well as the clinical outcomes 12 and 24 months after surgery. Results A total of 34 patients were included in both the study group (age mean 33.3 ± SD 8.8 years) and the control group (33.6 ± 8.4 years) with a median defect size of 466 (25%-75% IQR 375–600) mm2 and 425 (IQR 375–600) mm2, respectively. In comparison with the preoperative state (median 67, IQR 52–75), the study group showed a significant increase of the total KOOS after 12 months (78, IQR 70–86; p = 0.014) and after 24 months (81, IQR 70–84; p = 0.001). The NAS for pain did not change significantly in the postoperative course. In comparison with the control group there was no significant difference for the total KOOS neither preoperative (control group median 67, IQR 52–73) nor at any postoperative time point (12 months: 82, IQR 67–93; 24 months: 81, IQR 71–91). Conclusion The clinical short-term outcomes after ACI at the knee joint in combination with ACL reconstruction are good and similar to the results after isolated ACI in ligament intact knees. Level of evidence III.
      PubDate: 2022-10-01
       
  • Anterior tibial subluxation measured under a modified protocol is
           positively correlated with posterior tibial slope: a comparative study of
           MRI measurement methods

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      Abstract: Purpose Anatomic factors, such as posterior tibial slope (PTS) and anterior tibial subluxation (ATS) obtained by quantitative measurement, have been proposed as predictors for clinical outcomes of anterior cruciate ligament (ACL) reconstruction. However, the correlation between PTS and ATS is controversial, and the method for quantitative ATS measurement remains unsettled. This study aimed to identify the correlation between PTS and ATS in patients with injured and intact ACLs and compare the two ATS measuring protocols. Methods This study included 128 ACL-injured and 176 ACL-intact patients with no concomitant ligament injuries. PTS and ATS were measured on sagittal MRI. ATS was measured using two measuring protocols, including the modified protocol using the longitudinal tibial axis (axis protocol) and the established protocol using a line perpendicular to the tibial plateau (plateau protocol). Correlation analyses between PTS and ATS and between PTS and the difference in the ATS value measured under the two protocols (ATSdiff) were performed. The difference between the two ATS measuring protocols was further analyzed by trigonometric analysis. Intra- and interobserver reliability tests were performed for the axis protocol. Results Under the axis protocol, ATS was positively correlated with PTS in both the ACL-injured and ACL-intact groups (p < 0.001). Under the plateau protocol, no correlation was observed in the ACL-injured group. In the ACL-intact group, no correlation was observed for lateral ATS, and a negative correlation was observed for medial ATS (p = 0.001). ATSdiff was positively correlated with PTS (p < 0.001), indicating that the two protocols varied greatly in those with a steep PTS. Trigonometric analysis showed that a steep PTS influenced the measurement of ATS under the plateau protocol but not the axis protocol. Intra- and interobserver reliability tests showed good-to-excellent strength of reliability for the ATS measurement under the axis protocol. Conclusion ATS measured under the axis protocol was positively correlated with PTS, indicating that a steep PTS was associated with a worse anatomic tibiofemoral relationship. The axis protocol for ATS measurement is a promising method for clinical use since it is not influenced by PTS and reflects the global position of the tibia. Level of evidence III.
      PubDate: 2022-10-01
       
 
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