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대한슬관절학회> Knee Surgery & Related Research(구 대한슬관절학회지)> Navigated versus Conventional Technique in High Tibial Osteotomy: A Meta-Analysis Focusing on Weight Bearing Effect

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Navigated versus Conventional Technique in High Tibial Osteotomy: A Meta-Analysis Focusing on Weight Bearing Effect

Kyung Wook Nha , Young-soo Shin , Hyuk Min Kwon , Jae Ang Sim , Young Gon Na
  • : 대한슬관절학회
  • : Knee Surgery & Related Research(구 대한슬관절학회지) 31권2호
  • : 연속간행물
  • : 2019년 06월
  • : 81-98(18pages)

DOI


목차

Introduction
Materials and Methods
Results
Discussion
Conclusions
Conflict of Interest
References

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초록 보기


						
Purpose: We aimed to determine whether navigated opening wedge high tibial osteotomy (HTO) is superior to the conventional technique in terms of accuracy of the coronal and sagittal alignment correction, functional outcome, and operative time.
Methods: Studies comparing navigated and conventional HTO were included in this meta-analysis. We compared the incidence of radiological outliers in coronal alignment and tibial slope maintenance, mean differences in functional outcome scales, and operative time. Subgroup analyses were performed on coronal alignment accuracy based on the intraoperative method of alignment confirmation: fluoroscopy vs. gap measurement method.
Results: Twelve studies were included: there were 434 knees in the navigated HTO studies and 405 knees in the conventional HTO studies. The risk of outlier was lower in navigated HTO than in conventional HTO; however, the difference was not significant when navigated HTO was compared with conventional HTO performed using the gap measurement method. Tibial slope maintenance was comparable or better in navigated HTO. No difference was found in the American Knee Society function and Lysholm scores. Navigated HTO necessitated a longer operative time of approximately 10 minutes.
Conclusions: The use of navigation in HTO can improve accuracy in both coronal and sagittal alignments, but its clinical benefit is unclear.

UCI(KEPA)

I410-ECN-0102-2019-500-001597353

간행물정보

  • : 의약학분야  > 정형외과학
  • : KCI등재
  • :
  • : 계간
  • : 1225-1623
  • : 2234-2451
  • : 학술지
  • : 연속간행물
  • : 1989-2019
  • : 1160


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1Navigated versus Conventional Technique in High Tibial Osteotomy: A Meta-Analysis Focusing on Weight Bearing Effect

저자 : Kyung Wook Nha , Young-soo Shin , Hyuk Min Kwon , Jae Ang Sim , Young Gon Na

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 31권 2호 발행 연도 : 2019 페이지 : pp. 81-98 (18 pages)

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초록보기

Purpose: We aimed to determine whether navigated opening wedge high tibial osteotomy (HTO) is superior to the conventional technique in terms of accuracy of the coronal and sagittal alignment correction, functional outcome, and operative time.
Methods: Studies comparing navigated and conventional HTO were included in this meta-analysis. We compared the incidence of radiological outliers in coronal alignment and tibial slope maintenance, mean differences in functional outcome scales, and operative time. Subgroup analyses were performed on coronal alignment accuracy based on the intraoperative method of alignment confirmation: fluoroscopy vs. gap measurement method.
Results: Twelve studies were included: there were 434 knees in the navigated HTO studies and 405 knees in the conventional HTO studies. The risk of outlier was lower in navigated HTO than in conventional HTO; however, the difference was not significant when navigated HTO was compared with conventional HTO performed using the gap measurement method. Tibial slope maintenance was comparable or better in navigated HTO. No difference was found in the American Knee Society function and Lysholm scores. Navigated HTO necessitated a longer operative time of approximately 10 minutes.
Conclusions: The use of navigation in HTO can improve accuracy in both coronal and sagittal alignments, but its clinical benefit is unclear.

2Arthroscopic Treatment of Popliteal Cysts with and without Cystectomy: A Systematic Review and Meta-Analysis

저자 : Ji Hoon Han , Ji Hoon Bae , Kyung Wook Nha , Young Soo Shin , Dae Hee Lee , Hyun Jae Sung , Jae Gyoon Kim

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 31권 2호 발행 연도 : 2019 페이지 : pp. 103-112 (10 pages)

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Purpose: To compare the clinical outcomes of the arthroscopic treatments for popliteal cysts with and without cystectomy.
Methods: PubMed/MEDLINE, EMBASE, KoreaMed, and Cochrane Library were searched from the earliest available date of indexing through August 2016. The methodological quality of all articles was assessed according to the Coleman methodology score (CMS). Studies were grouped according to the surgical method, and a meta-analysis was conducted to identify the unsuccessful clinical outcome and complication rates.
Results: Nine studies were included; the mean CMS was 67.33 (standard deviation, 8.75 points). Cystectomy was reported in five studies; cystectomy was not performed in four studies. The odds ratio of unsuccessful clinical outcomes evaluated by Rauschning and Lindgren score was 122.05 (p<0.001) with cystectomy and 58.12 (p<0.001) without cystectomy. The effect size of complications was 0.16 (p<0.001) with cystectomy and 0.03 (p<0.001) without cystectomy. The recurrence rate was 0% with cystectomy and 6.4% without cystectomy.
Conclusions: All the currently available studies showed satisfactory outcomes in both with and without cystectomy groups. However, arthroscopic cystectomy concurrently performed with management of intra-articular lesions was associated with a relatively low recurrence rate and a relatively high incidence of complications.

3Beta- Tricalcium Phosphate Block for Donor Site Morbidity of the Patella in Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Graft

저자 : Yuki Kato , Joverienne Chavez , Shin Yamada , Soichi Hattori , Shuzo Takazawa , Hiroshi Ohuchi

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 31권 2호 발행 연도 : 2019 페이지 : pp. 113-119 (7 pages)

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Purpose: This study aimed to investigate anterior knee symptoms in patients who underwent anterior cruciate ligament (ACL) reconstruction using bone-patellar tendon-bone (BPTB) graft followed by implantation of a beta-tricalcium phosphate (β-TCP) block as a bone void filler.
Materials and Methods: We retrospectively reviewed 84 cases of synthetic bone grafting using a β-TCP block for the patellar bone defect in ACL reconstruction with a BPTB autograft. Computed tomography of the operated knee was performed immediately after the surgery to evaluate whether the grafted β-TCP block protruded forward from the anterior surface of the patella. On the basis of the results, the cases were divided into a protrusion group (n=31) and a non-protrusion group (n=53). Anterior knee symptoms at 12 months postoperatively and absorption of the grafted β-TCP block were compared between the two groups.
Results: Except for patellofemoral crepitus, there was no significant difference in anterior knee symptoms between the two groups (p>0.05). The incidence of patellofemoral crepitus was significantly lower in the protrusion group than in the non-protrusion group (p=0.027). The groups showed no significant difference in β-TCP absorption.
Conclusions: The present study demonstrated that the protrusion of β-TCP that was used as a bone void filler had no adverse effects.

4Time-Dependent Increase in Medial Meniscus Extrusion after Medial Meniscus Posterior Root Tear Analyzed by Using Magnetic Resonance Imaging

저자 : Yoshiki Okazaki , Takayuki Furumatsu , Yasunori Shimamura , Kenta Saiga , Hideki Ohashi , Takahiko Uchino , Yusuke Kamatsuki , Yuki Okazaki , Toshifumi Ozaki

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 31권 2호 발행 연도 : 2019 페이지 : pp. 120-125 (6 pages)

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Purpose: Medial meniscus posterior root tear (MMPRT) causes progression of medial meniscus extrusion (MME). This study aims to calculate the progression rate of MME based on findings in two preoperative magnetic resonance imaging (MRI) scans and determine the associated factors.
Materials and Methods: We retrospectively reviewed 33 patients (27 females and 6 males; mean age, 60 years) who underwent MRI twice, at a mean interval of 48 days. We measured the medial meniscus body width, medial joint space width (MJSW), and MME. The MME progression rate was derived from regression analysis of the increase in MME (ΔMME) between the two MRI scans. In addition, the correlations of the MME increase rate with age, body mass index, femorotibial angle, and MJSW were evaluated.
Results: The mean MME increased from 3.4 mm to 4.5 mm (p<0.001). A good correlation was observed between ΔMME and the interval of MRI scans (R2=0.621), and the MME progression rate was 0.020 mm per day. A moderate correlation was observed between the MME increase rate and the MJSW (R2=0.432).
Conclusions: The MME progression rate was rapid in MMPRT and narrowing of the MJSW was associated with the progression of MME. Level of Evidence: V, Cross-sectional study

5Disparity between Preoperative Target Correction Amount and Postoperative Correction Amount in Open Wedge High Tibial Osteotomy

저자 : O-sung Lee , Eui Soo Lee , Yong Seuk Lee

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 31권 2호 발행 연도 : 2019 페이지 : pp. 126-131 (6 pages)

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Purpose: The purpose of this study was to evaluate the disparity between the preoperative target correction amount and the postoperative correction amount in open wedge high tibial osteotomy (OWHTO) in patients divided according to the planned osteotomy gap.
Materials and Methods: Seventy-two patients were divided into two groups (group 1 with the planned opening gap lager than the mean opening gap length of total patients and group 2 with a smaller opening gap). The opening gap was determined according to the target weight bearing line (WBL) ratio on the preoperative whole leg radiograph. Absolute and relative values of the disparity between the target and postoperative WBL ratios were compared between groups in order to clarify whether the disparity was deviated toward over- or under-correction.
Results: The absolute value of disparity between the target and postoperative WBL ratios in group 1 was significantly larger than that in group 2 (6.01%±5.68% vs. 3.32%±3.38%; p=0.02). However, there was no statistically significant difference in relative values between groups (p=0.54).
Conclusions: The postoperative WBL ratio after OWHTO was different from the preoperative target WBL ratio if the planned osteotomy gap was large. This mismatch was not deviated toward one side, either over- or under-correction.

6The Migratory Cortical Button: A Rare Case of Hypersensitivity to Titanium after an Anterior Cruciate Ligament Reconstruction

저자 : Nicolas Bouguennec , Philippe Colombet , Nicolas Graveleau , Stephane Jambou

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 31권 2호 발행 연도 : 2019 페이지 : pp. 132-136 (5 pages)

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Allergy to metal, especially to titanium, is a poorly known subject in orthopedic surgery and is mostly found after arthroplasty. Here, we describe an original case of titanium allergy that developed after an anterior cruciate ligament (ACL) reconstruction of the left knee in a patient with a history of severe atopic dermatitis. Three years after the surgery, he returned to the clinic with the femoral cortical button in his hand; he removed the device from the wound when the skin spontaneously opened at the lateral part of the thigh. The wound healed with dressings without use of any antibiotics. Clinical and functional results were favorable and magnetic resonance imaging signal of the graft was normal. We ruled out the possibility of infection and the final diagnosis was allergy to titanium. This case demonstrates the need to investigate the presence of allergy to metal, including titanium, before an ACL reconstruction.

7Femoral Avulsion of the Anterior Cruciate Ligament in a Multiligament Setting: A Unique Case

저자 : Vikram Arun Mhaskar , Jitendra Mahehswari , Manjeet Sansanwal

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 31권 2호 발행 연도 : 2019 페이지 : pp. 137-142 (6 pages)

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Anterior cruciate ligament (ACL) femoral avulsions are a rare entity mainly seen in children. We describe a unique case of a bony ACL avulsion with a medial collateral ligament (MCL) and lateral meniscus (LM) tear in a 37-year-old patient who sustained a two-wheeler accident. The ACL femoral avulsion was fixed arthroscopically using a Knee Scorpion and a FiberTape fixed over a suture disc on the lateral cortex. The MCL was repaired with an internal brace using a FiberTape and two SwiveLocks and the torn LM was repaired using all-inside sutures. At 2 years of follow-up, the fragment was united, knee range of motion was 0° to 130°, and Knee Society Score was 98. This is the first case report of a femoral avulsion of the ACL combined with an MCL injury and a meniscus tear where all three were repaired with a unique technique and good results were obtained.

8Treatment of Osteochondritis Dissecans of the Knee with Autologous Iliac Bone Graft and Hyaluronic Acid Scaffold

저자 : Jaime Hinzpeter , Alvaro Zamorano , Maximiliano Barahona , Pablo Campos

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 31권 2호 발행 연도 : 2019 페이지 : pp. 143-146 (4 pages)

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Osteochondritis dissecans (OCD) is a condition that corresponds to an idiopathic focal lesion affecting the subchondral bone with possible compromise of the stability of the adjacent cartilage. Treatment depends on the size of the lesion, cartilage stability, and the physeal status. The case reported is about an 18-year-old male patient who complained of suffering from knee pain for a period of ten months. Magnetic resonance imaging (MRI) revealed a lesion of 2 cm2 in the medial femoral condyle that compromised the subchondral bone, compatible with OCD. He underwent surgery that consisted of filling the subchonral defect with an iliac crest autograft and sealing the defect with a hyaluronic acid scaffold. At the 12-month follow-up, the MRI shows complete healing and the patient has resumed sports activities. Management with autologous iliac crest graft and hyaluronic acid scaffold represents an effective alternative treatment for OCD.

9Snapping Knee due to a Femoral Osteochondroma after Total Knee Arthroplasty

저자 : Sang Jun Song , Dae Kyung Bae , Cheol Hee Park

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 31권 2호 발행 연도 : 2019 페이지 : pp. 147-150 (4 pages)

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A female patient who underwent total knee arthroplasty presented with a snapping sensation over the left knee at 10 years postoperatively. Initially, the bony mass was visible on the medial femoral condyle radiographically at 5 years postoperatively. The mass had enlarged over time and her symptoms were progressive. The mass was excised at postoperative 18 years and confirmed as an osteochondroma histopathologically. The patient's symptoms have been completely resolved for 3-year follow-up after excision.
Level of Evidence: V

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