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대한슬관절학회> Knee Surgery & Related Research(구 대한슬관절학회지)

Knee Surgery & Related Research(구 대한슬관절학회지) update

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  • : 대한슬관절학회지(~2010) → knee surgery & related research(2011~)

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수록범위 : 1권1호(1989)~33권0호(2021) |수록논문 수 : 1,270
Knee Surgery & Related Research(구 대한슬관절학회지)
33권0호(2021년 09월) 수록논문
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1Outcomes of one-stage reconstruction for chronic multiligament injuries of knee

저자 : Tarun Goyal , Souvik Paul , Sushovan Banerjee , Lakshmana Das

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 33권 0호 발행 연도 : 2021 페이지 : pp. 1-10 (10 pages)

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Purpose: This article aims to evaluate patterns of chronic multiligament injuries and outcomes of treatment with single-stage reconstruction using autografts.
Methods: All patients with clinicoradiologically diagnosed multiligament knee injury (MKI) were included in this prospective observational study. As the time since injury was more than 6 weeks in all of the patients, they were categorized as having chronic MKI. Patients were assessed clinically for laxity, and the diagnosis was confirmed radiologically. Ipsilateral hamstring tendons were used for medial collateral ligament (MCL) or posterolateral corner reconstruction in a patient with Schenck knee dislocation (KD) type III. In these cases, the posterior cruciate ligament (PCL) and anterior cruciate ligament (ACL) were reconstructed by using the peroneus longus and contralateral hamstring tendons respectively. Ipsilateral hamstring tendons were used for ACL reconstruction and an ipsilateral peroneus longus tendon graft was used for reconstruction of the PCL in a KD type II injury. In two cases of KD type IV injury, the lateral laxity was only grade II and was managed conservatively; the rest of the ligaments were addressed like a KD type III injury. Outcome evaluation was done using a visual analogue scale (VAS) for pain, International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner activity level, preoperatively and postoperatively at 2 years' follow-up.
Results: A total of 27 patients of mean age 33.48 ± 9.9 years with MKI were included in the study. The patients were classified as eight KD type II, 17 KD type III, and two KD type IV. The majority of the patients had associated meniscal (59.2%) or chondral (40.7%) injuries. At the 2 years' follow-up visit, there were significant improvements in VAS score (p = 0.0001) IKDC score (p = 0.0001), Lysholm score (p = 0.0001), and range of motion (p = 0.001). None of the patients had residual laxity on clinical examination of the knee joint at the 2 years' follow-up. All but two of the patients went back to their previous activity level. These two patients had progressive knee arthritis and needed knee arthroplasty.
Conclusion: Single-stage surgical reconstruction for chronic MKI has favourable functional outcomes.
Level of evidence: Level IV, case series.

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2Asia-Pacific venous thromboembolism consensus in knee and hip arthroplasty and hip fracture surgery: Part 1. Diagnosis and risk factors

저자 : Srihatach Ngarmukos , Kang-il Kim , Siwadol Wongsak , Thanainit Chotanaphuti , Yutaka Inaba , Cheng-fong Chen , David Liu

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 33권 0호 발행 연도 : 2021 페이지 : pp. 1-13 (13 pages)

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3The association between bone mineral density and postoperative drainage volume following cruciate-substituting primary total knee arthroplasty: a cross-sectional study

저자 : Yuthasak Peerakul , Jirapong Leeyaphan , Karn Rojjananukulpong

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 33권 0호 발행 연도 : 2021 페이지 : pp. 1-7 (7 pages)

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Background: The prevalence of osteoporosis in patients who undergo a primary total knee arthroplasty (TKA) is increasing. Low bone mineral density (BMD) is related to unfavorable outcomes following TKA such as migration of uncemented tibial components. Postoperative blood loss in TKA is an important complication. Non-modifying predicting factors for postoperative blood loss in patients undergoing primary TKA need further elucidation. Studies on the association between BMD and blood loss after TKA are limited. We aimed to demonstrate the relationship between BMD and postoperative drainage volume following primary TKA.
Methods: A cross-sectional study was conducted between January 2014 and August 2020. A total of 119 primary varus osteoarthritis knees with BMD results were included in the study. Patients with secondary causes of osteoporosis were excluded.
Results: The median postoperative drainage volume of participants in the normal total hip BMD group and the normal trochanter BMD group was higher than that of patients in the low total hip BMD group and the low trochanter BMD group (285.0 ml vs 230.0 ml, P = 0.003; 282.5 ml vs 240.0 ml, P = 0.013, respectively). Multivariate regression analyses showed that operative time, spinal anesthesia, and normal total hip BMD status were significant predictive factors associated with increased postoperative drainage volume (P = 0.014, 0.022, and 0.013, respectively). No association was identified between the lumbar spine BMD status and postoperative drainage volume.
Conclusions: The relationship between BMD and postoperative blood loss in primary TKA was identified in this study. Normal total hip BMD was found to be associated with an increased postoperative drainage volume after primary TKA compared with low BMD.

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4Clinical outcomes of two-stage revision total knee arthroplasty in infected cases with antibiotic-loaded cement spacers produced using a handmade silicone mold

저자 : Takashi Hoshino , Toshifumi Watanabe , Yusuke Nakagawa , Hiroki Katagiri , Nobutake Ozeki , Toshiyuki Ohara , Mikio Shioda , Yuji Kono , Ichiro Sekiya , Hideyuki Koga

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 33권 0호 발행 연도 : 2021 페이지 : pp. 1-7 (7 pages)

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Purpose: This study assessed the clinical outcomes of periprosthetic joint infection patients who underwent twostage revision total knee arthroplasty with antibiotic-loaded cement spacers fabricated using a handmade silicone mold.
Materials and methods: This study included seven patients (average age 77 years, average follow-up time 54 months) who underwent surgery at our hospital between 2009 and 2013. Clinical outcomes including knee scores, function scores, knee range of motion, and walking ability at the final observation, period from the primary total knee arthroplasty to implant removal, period from implant removal to revision total knee arthroplasty, and followup period after revision total knee arthroplasty were investigated.
Results: At the final follow-up, the average knee range of motion was 99°, with no significant differences at each stage; average knee and function scores were 84 and 77, respectively. With cement spacers, five patients were able to walk with a t-cane. No recurrence of infection was observed.
Conclusions: The clinical outcomes of the current case series demonstrated good knee function with preserved walking ability, without any recurrence of periprosthetic joint infection. This study suggests that using a handmade silicone mold could be an effective option for periprosthetic joint infection after a total knee arthroplasty.

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5Bone remodeling and implant migration of uncemented femoral and cemented asymmetrical tibial components in total knee arthroplasty - DXA and RSA evaluation with 2-year follow up

저자 : Müjgan Yilmaz , Christina Enciso Holm , Thomas Lind , Gunnar Flivik , Anders Odgaard , Michael Mørk Petersen

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 33권 0호 발행 연도 : 2021 페이지 : pp. 1-13 (13 pages)

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Background: Aseptic loosening is one of the major reasons for late revision in total knee arthroplasty (TKA). The risk of aseptic loosening can be detected using radiostereometric analysis (RSA), whereby micromovements (migration) can be measured, and thus RSA is recommended in the phased introduction of orthopedic implants. Decrease in bone mineral density (BMD), as measured by dual-energy x ray absorptiometry (DXA), is related to the breaking strength of the bone, which is measured concurrently by RSA. The aim of the study was to evaluate bone remodeling and implant migration with cemented asymmetrical tibial and uncemented femoral components after TKA with a follow up period of 2 years.
Methods: This was a prospective longitudinal cohort study of 29 patients (number of female/male patients 17/12, mean age 65.2 years), received a hybrid Persona® TKA (Zimmer Biomet, Warsaw, IN, USA) consisting of a cemented tibial, an all-polyethylene patella, and uncemented trabecular metal femoral components. Follow up: preoperative, 1 week, and 3, 6, 12 and 24 months after surgery, and double examinations for RSA and DXA were performed at 12 months. RSA results were presented as maximal total point of motion (MTPM) and segmental motion (translation and rotation), and DXA results were presented as changes in BMD in different regions of interest (ROI).
Results: MTPM at 3, 6, 12, and 24 months was 0.65 mm, 0.84 mm, 0.92 mm, and 0.96mm for the femoral component and 0.54 mm, 0.60 mm, 0.64 mm, and 0.68 mm, respectively, for the tibial component. The highest MTPM occurred within the first 3 months. Afterwards most of the curves flattened and stabilized. Between 12 and 24 months after surgery, 16% of femoral components had migrated by more than 0.10mm and 15% of tibial components had migrated by more than 0.2 mm. Percentage change in BMD in each ROI for distal femur was as follows: ROI I 26.7%, ROI II 9.2% and ROI III 3.3%. BMD and at the proximal tibia: ROI I 8.2%, ROI II 8.6% and ROI III 7.0% after 2 years compared with 1 week postoperative results. There was no significant correlation between maximal percentwise change in BMD and MTPM after 2 years.
Conclusion: Migration patterns and changes in BMD related to femoral components after TKA in our study correspond well with previous studies; we observed marginally greater migration with the tibial component.

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6Tibial-graft fixation methods on anterior cruciate ligament reconstructions: a literature review

저자 : Vitor Luis Pereira , João Victor Medeiros , Gilvan Rodrigues Silva Nunes , Gabriel Taniguti De Oliveira , Alexandre Pedro Nicolini

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 33권 0호 발행 연도 : 2021 페이지 : pp. 1-8 (8 pages)

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Introduction: Anterior cruciate ligament (ACL) reconstruction is the most performed orthopedic surgical procedure.
The result of ACL reconstructions depends on multiple technical variables, including tension to be applied to the graft for fixation, knee-flexion angle during fixation and the type of fixation to the bone.
Objective: To carry out a survey of the literature with the best evidence on these themes.
Methods: Literature review about methods of tibial-graft fixation in ACL reconstructions - tension applied at the time of fixation, type of graft fixation, and knee-flexion degree during tibial fixation.
Results: Thirty studies on the selected topics were found. Most studies point to graft-tension levels close to 90 N to obtain the best results. Regarding the knee-flexion angle, multiple studies suggest that fixation at a 30° angle would bring superior biomechanical advantages. Regarding the type of implant for fixation, it is not possible to affirm the superiority of one method over another in clinical outcomes.
Conclusions: There is no consensus on the best method for tibial fixation of the grafts in ACL reconstructions regarding tension, type of implant and knee-flexion angle. However, the analysis of the studies pointed to certain trends and allowed the drawing of specific conclusions.

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7Trends of arthroscopy publications in PubMed and Scopus

저자 : Srinivas B. S. Kambhampati , Abhishek Vaish , Raju Vaishya , Mohit Kumar Patralekh

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 33권 0호 발행 연도 : 2021 페이지 : pp. 1-8 (8 pages)

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Purpose: Arthroscopy is an established sub-speciality in orthopaedics. With advancing technology, instrumentation and implants, this sub-speciality has seen an explosion of knowledge and techniques since its inception. The indications for arthroscopic management are increasing and, hence, the number of publications on this topic. There has been no study looking into the bibliometrics of all publications within this speciality. The purpose of this study was to look into the trends of published articles on arthroscopy from PubMed and Scopus including studying their citation numbers.
Materials and methods: We set out to look into the number of publications from the earliest up to 2019 and their trends and citation numbers in PubMed and Scopus. We also performed a VOS viewer analysis of MeSH terms and titles of publications to look at research trends over time.
Results: There were 41,149 articles published on PubMed since 1955 and 50,373 articles on Scopus since 1939. The total number of citations were 912,630 for 38,338 cited articles. With 2864 publications in 2019, there was a more than four-fold increase from the number published in the year 2000. The knee joint was the most frequently published joint with an increasing trend in hip arthroscopy. Cohort studies were the most common with 13,180 articles followed by Reviews with 5746 articles. The top 10 authors, universities and journals were listed along with citation numbers. We analysed the trends of publications for each joint and compared them. Yearly citations have progressively increased to reach a maximum of 45,407 in 2007. Arthroscopy was the most published and cited journal on this topic. The Journal of Bone and Joint Surgery (JBJS) (Am) had the most citations per article. The USA and Hospital for Special Surgery, New York were the most published country and university, respectively.
Conclusions: There is a healthy growth of publications on the subject of arthroscopy with a steep increase in the number of publications and citations in recent years. VOS Viewer analysis showed an evolution of research and practice in the field of arthroscopy. Recommendations were made for databases and search engines to improve on the search and analysis of such studies in the future.
Level of evidence: 4

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9Immediate weight-bearing is safe following lateral locked plate fixation of periprosthetic distal femoral fractures

저자 : Oisin J. F. Keenan , Lauren A. Ross , Matthew Magill , Matthew Moran , Chloe E. H. Scott

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 33권 0호 발행 연도 : 2021 페이지 : pp. 1-10 (10 pages)

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Purpose: This study aimed to determine whether unrestricted weight-bearing as tolerated (WBAT) following lateral locking plate (LLP) fixation of periprosthetic distal femoral fractures (PDFFs) is associated with increased failure and reoperation, compared with restricted weight-bearing (RWB).
Materials and methods: In a retrospective cohort study of consecutive patients with unilateral PDFFs undergoing LLP fixation, patients prescribed WBAT were compared with those prescribed 6 weeks of RWB. The primary outcome measure was reoperation. Kaplan-Meier and Cox multivariable analyses were performed.
Results: There were 43 patients (mean age 80.9 ± 11.7 years, body mass index 26.8 ± 5.7 kg/m2 and 86.0% female): 28 WBAT and 15 RWB. There were more interprosthetic fractures in the RWB group (p = 0.040). Mean follow-up was 3.8 years (range 1.0-10.4). Eight patients (18.6%) underwent reoperation. Kaplan-Meier analysis demonstrated no difference in 2-year survival between WBAT (80.6%, 95% CI 65.3-95.9) and RWB (83.3%, 95% CI 62.1-100.0; p = 0.54). Cox analysis showed increased reoperation risk with medial comminution (hazard ratio 10.7, 95% CI 1.5-80; p = 0.020) and decreased risk with anatomic reduction (hazard ratio 0.11, 95% CI 0.01-1.0; p = 0.046). Immediate weightbearing did not significantly affect the risk of reoperation compared with RWB (relative risk 1.03, 95% CI 0.61-1.74; p = 0.91).
Conclusions: LLP fixation failure was associated with medial comminution and non-anatomic reductions, not with postoperative weight-bearing. Medial comminution should be managed with additional fixation. Weight-bearing restrictions additional to this appear unnecessary and should be avoided.

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10Comparison of post-operative threedimensional and two-dimensional evaluation of component position for total knee arthroplasty

저자 : Osamu Tanifuji , Tomoharu Mochizuki , Hiroshi Yamagiwa , Takashi Sato , Satoshi Watanabe , Hiroki Hijikata , Hiroyuki Kawashima

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 33권 0호 발행 연도 : 2021 페이지 : pp. 1-11 (11 pages)

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Purpose: The purpose of this study was to evaluate the post-operative three-dimensional (3D) femoral and tibial component positions in total knee arthroplasty (TKA) by the same co-ordinates' system as for pre-operative planning and to compare it with a two-dimensional (2D) evaluation.
Materials and methods: Sixty-five primary TKAs due to osteoarthritis were included. A computed tomography (CT) scan of the femur and tibia was obtained and pre-operative 3D planning was performed. Then, 3D and 2D postoperative evaluations of the component positions were performed. KneeCAS (LEXI, Inc., Tokyo, Japan), a lowerextremity alignment assessment system, was used for the 3D post-operative evaluation. Standard short-knee radiographs were used for the 2D post-operative evaluation. Differences between the pre-operative planning and post-operative coronal and sagittal alignment of components were investigated and compared with the results of the 3D and 2D evaluations.
Results: According to the 3D evaluation, the difference between the pre-operative planning and actual postoperative sagittal alignment of the femoral component and the coronal and sagittal alignments of the tibial component were 2.6° ± 1.8°, 2.2° ± 1.8° and 3.2° ± 2.4°, respectively. Using the 2D evaluation, they were 1.9° ± 1.5°, 1.3° ± 1.2° and 1.8° ± 1.4°, making the difference in 3D evaluation significantly higher (p = 0.013, = 0.003 and < 0.001). For the sagittal alignment of the femoral component and the coronal and sagittal alignment of the tibial component, the outlier ( > ± 3°) ratio for the 3D evaluation was also significantly higher than that of the 2D evaluation (p < 0.001, = 0.009 and < 0.001).
Conclusions: The difference between the pre-operative planning and post-operative component alignment in the 3D evaluation is significantly higher than that of the 2D, even if the same cases have been evaluated. Twodimensional evaluation may mask or underestimate the post-operative implant malposition. Three-dimensional evaluation using the same co-ordinates' system as for pre-operative planning is necessary to accurately evaluate the post-operative component position.

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