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To compare the clinical efficacy of ACL reconstruction using the Mitek bone–tendon–bone cross pin (RIGIDfix) to the Linvatec Bioscrew (control device).Forty subjects were randomized into one of two groups: the RIGIDfix or control group. Eligible subjects were male and female, 18years of age and older, with an ACL injury of at least 3weeks duration and no evidence of ACL insufficiency on the contralateral...
Hamstring tendon autograft has become a popular graft choice for anterior cruciate ligament (ACL) reconstruction, but there is no consensus on the ideal technique of fixation. We performed a pilot randomized controlled study to compare the clinical and mechanical outcome of two femoral fixation techniques for anterior cruciate ligament (ACL) reconstruction using hamstrings graft. We recruited 30 patients...
Many studies have shown that computer navigation in total knee arthroplasty aids the surgeon to place the prosthesis in a more accurate overall alignment. Bony resection creates the flexion and extension gaps; important in balancing the knee and implant selection in TKR. The computer plans the bone cuts but has variables that it cannot control: the surgeon, the saw blade thickness and oscillation,...
The purpose of the current study was to compare midterm outcomes of posterior cruciate-retaining (CR) versus posterior cruciate-substituting (PS) procedures using the Genesis II total knee arthroplasty (TKA) system (Smith and Nephew, Memphis, TN). Ninety-nine (99) CR and 93 PS TKA's were analyzed in this prospective, randomized clinical trial. Surgeries were performed at seven medical centers by participating...
The open-wedge high tibial osteotomy (OWHTO) is a well accepted treatment modality for patients with osteoarthritis of the medial compartment associated with genu varum. To fill in the osteotomy gap 30% macroporosity rigid beta-tricalcium phosphate (β-TCP) is frequently used as a stable resorbable bone substitute. However, the resorbability of these β-TCP wedges is not known. The aim of this study...
The role of frontal plane tibiofemoral alignment in subjects with patellofemoral pain syndrome (PFPS) is controversial and rarely discussed in the literature. As well, little research has been done on the effects of the hamstrings muscles on PFPS. The aim of the current study was to determine whether, in individuals with PFPS, frontal plane tibiofemoral alignment or muscular activity of the index...
The objective of this study was to investigate the hypothesis that the increased constraint of a medial rotational knee promotes earlier loosening of the prosthesis. All patients with a Freeman-Samuelson 1000 knee arthroplasty (medial pivot design), (group 1), or a Freeman-Samuelson Modular knee arthroplasty, (group 2), with a minimum follow-up of 2 years (mean follow-up 4 years) were identified from...
We documented functional outcome in 83 knees with tibial spine fractures. The mean age at injury was 35 years. There was a medial collateral ligament sprain in 17 knees and posterolateral corner injury in three knees. Twenty patients with displaced tibial spine fractures were treated with fixation of the tibial spine and 63 patients with undisplaced or minimally displaced fractures were treated non-operatively...
Total Knee Arthroplasty (TKA) changes mechanical loading of the knee joint. Bone loss in the tibia is commonly encountered at the time of the revision TKA. Restoration of lost bone support and joint stability are the primary challenges in revision TKA. Normally, these defects are treated with non-living structures like metallic augments or bone grafts (autografts or allografts). Alone, neither of...
Arthroscopy continues to be widely used in the management of knee osteoarthritis despite concerns regarding its effectiveness. The Scottish Arthroplasty Project has demonstrated a three-fold variation in rates of arthroscopy for osteoarthritis of the knee across different regions of Scotland. This has clear ramifications for the utilisation of finite health care resources. In light of such variations...
Patellofemoral arthroplasty (PFA) is an accepted procedure for the treatment of isolated patellofemoral osteoarthritis. However its failure rate has been attributed to progressive femorotibial arthritis. Autologous osteochondral transplantation is an established procedure for the repair of focal cartilaginous defects on the medial and lateral femoral condyles. We present our case series of six knees...
The proximal tibia metaphysis is a potential alternative donor site for a sufficient amount of cancellous bone, associated with low morbidity and complication rate. We performed an observational computed tomography imaging study to determine the volume of cancellous bone that can be harvested from the proximal tibia compared to the anterior iliac crest, based on an advanced three-dimensional medical...
The treatment of patients with osteoarthritic knees accompanied by ipsilateral osteoarthritic ankles is not well documented. We here report both clinical results and radiographic evaluations of such patients treated using a high tibial osteotomy (HTO). HTO was performed on 16 knees of 10 patients (all women with a mean age; 68years; range 58 to 73years) who had a varus deformity of both their legs...
Non-union following high tibial osteotomy (HTO) is very uncommon. We present a case of bilateral non-union of HTOs with end-stage knee arthritis treated with staged, bilateral, posterior stabilized knee replacements. A 77-year-old female presented to our clinic with complaints of debilitating knee pain. She used a frame to get about in her home, she was unable to get up stairs, and she rarely went...
Mobile-bearing (MB) total knee arthroplasty (TKA) was developed as an alternative to the established fixed-bearing (FB) design because of theoretical advantages. Short-term studies comparing these designs have not shown any differences in clinical and radiographic results. We compared the results at 7 years of a randomised study of patients undergoing TKA using either a FB or a MB variant of the same...
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