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Advanced Knee Surgery
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Advanced Knee Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 20 August 2024 | Viewed by 3649

Special Issue Editor

Dr. Ran Thein

E-Mail Website
Guest Editor
Department of Orthopedic Surgery, Chaim Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
Interests: knee biomechanics; robotic-assisted surgery; knee ligaments; sports injuries

Special Issue Information

Dear Colleagues,

There is significant progress that has been made in the orthopedic surgical field.

Knee surgical intervention has particularly seen great advancements over the last several years in the fields of ligament, meniscus, and cartilage repair; osteotomy surgeries; and arthroplasty.

The main aim of this Special Issue of the Journal of Clinical Medicine is to give the readers insight into the new advances in this field of advanced knee surgeries that are helping patients who are suffering from knee injuries, pathologies, or diseases. This Special Issue is open to studies that investigate new surgical techniques, surgical strategies and decision making, and clinical outcomes. Articles, systematic reviews, and meta-analyses are welcome.

The Scope of the Special Issue includes:

  • Meniscus surgery: repairs, allograft transplantation, or artificial meniscal transplantations.
  • Cartilage surgery: cartilage repair or implantation, marrow stimulation techniques, cell or stem-cell implantations.
  • Single- or multi-ligament surgery: repairs and reconstructions.
  • Patellar instability surgery: soft tissue repair, osteotomy. and trochleoplasty.
  • Osteotomy: femoral or tibial osteotomies, double-level osteotomies, and new fixation devices.
  • Arthroplasty: advances in techniques in unicompartmental or total arthroplasties, including robotic-assisted surgery.

Dr. Ran Thein
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • knee
  • ligament
  • cartilage
  • meniscus
  • arthroplasty
  • patellar dislocation
  • robotic-assisted surgery

Published Papers (4 papers)

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Research

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13 pages, 11761 KiB  
Article
The Effect of Severe Varus Deformity on Clinical and Radiographic Outcomes in Mechanical Aligned Total Knee Arthroplasty with Medial Stabilizing Technique
by Sung-Sahn Lee, Jewon Jung, Hanbit Kim, Jinwoo Kim, In Geol Jung, Jiin Kim and Young-Wan Moon
J. Clin. Med. 2024, 13(6), 1595; https://doi.org/10.3390/jcm13061595 - 11 Mar 2024
Viewed by 684
Abstract
Background: The purpose was to compare the clinical and radiographic outcomes between preoperative mild and severe varus deformity after total knee arthroplasty (TKA) with medial stabilizing technique (MST). Methods: We retrospectively analyzed 158 knees of 125 female patients with a 2-year follow-up who [...] Read more.
Background: The purpose was to compare the clinical and radiographic outcomes between preoperative mild and severe varus deformity after total knee arthroplasty (TKA) with medial stabilizing technique (MST). Methods: We retrospectively analyzed 158 knees of 125 female patients with a 2-year follow-up who underwent mechanically aligned TKA with MST between April 2018 and February 2021. Patients were divided into two groups; the severe varus group was defined as one with preoperative hip-knee ankle (HKA) angle ≥ 15° and the mild varus group with HKA angle < 15°. Pre- and post-operative clinical outcomes (Western Ontario and McMaster University Osteoarthritis Index, Knee Society Knee Score) and radiographic outcomes (medial proximal tibial angle (MPTA), HKA angle, lateral distal femoral angle (LDFA), joint line distance, and femoral component rotation angle) were compared between the groups. Results: Among the 158 knees analyzed, 131 and 27 were allocated to the mild and severe varus groups, respectively. Preoperative data showed that the MPTA (84.7° ± 2.8° vs. 80.7° ± 3.2°, p < 0.001) was significantly less in the severe varus group. In postoperative data, clinical outcomes were not different between the groups. Joint line distance (18.4 mm ± 2.8 mm vs. 18.6 mm ± 2.7 mm, p = 0.676) was also not significantly different. Femoral component rotation angle (−1.7° ± 1.0° vs. −1.0° ± 1.3°, p = 0.018) was more externally rotated in the severe varus group. Conclusions: Severe varus group showed comparable clinical and radiographic outcomes to that of mild varus group after mechanically aligned TKA with MST. Full article
(This article belongs to the Special Issue Advanced Knee Surgery)
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11 pages, 413 KiB  
Article
Delayed Meniscus Repair Lowers the Functional Outcome of Primary ACL Reconstruction
by Patrick Sadoghi, Harald K. Widhalm, Martin F. Fischmeister, Lukas Leitner, Andreas Leithner and Stefan F. Fischerauer
J. Clin. Med. 2024, 13(5), 1325; https://doi.org/10.3390/jcm13051325 - 26 Feb 2024
Viewed by 592
Abstract
Background: Our purpose was to evaluate whether the time of intervention and the type of meniscus surgery (repair vs. partial meniscectomy) play a role in managing anterior cruciate ligament (ACL) reconstructions with concurrent meniscus pathologies. Methods: We performed a prospective cohort study which [...] Read more.
Background: Our purpose was to evaluate whether the time of intervention and the type of meniscus surgery (repair vs. partial meniscectomy) play a role in managing anterior cruciate ligament (ACL) reconstructions with concurrent meniscus pathologies. Methods: We performed a prospective cohort study which differentiated between early and late ACL reconstructions with a cut-off at 3 months. Patients were re-evaluated after 2 years. Results: Thirty-nine patients received an operation between 2–12 weeks after the injury, and thirty patients received the surgery between 13–28 weeks after trauma. The strongest negative predictive factor of the International Knee Documentation Committee subjective knee form in a hierarchical regression model was older age (ß = −0.49 per year; 95% CI [−0.91; −0.07]; p = 0.022; partial R2 = 0.08)). The strongest positive predictive factor was a higher preoperative Tegner score (ß = 3.6; 95% CI [0.13; 7.1]; p = 0.042; partial R2 = 0.07) and an interaction between meniscus repair surgery and the time of intervention (ß = 27; 95% CI [1.6; 52]; p = 0.037; partial R2 = 0.07), revealing a clinical meaningful difference as to whether meniscus repairs were performed within 12 weeks after trauma or were delayed. There was no difference whether partial meniscectomy was performed early or delayed. Conclusions: Surgical timing plays a crucial role when surgeons opt for a meniscus repair rather than for a meniscectomy. Full article
(This article belongs to the Special Issue Advanced Knee Surgery)
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9 pages, 4026 KiB  
Article
Extension of the Medial Approach to the Tibial Plateau via an Osteotomy of the Tibial Insertion of the Superficial Medial Collateral Ligament
by Elmar Herbst, Moritz A. Wessolowski and Michael J. Raschke
J. Clin. Med. 2023, 12(16), 5208; https://doi.org/10.3390/jcm12165208 - 10 Aug 2023
Viewed by 983
Abstract
The treatment of medial tibial plateau fractures can be challenging due to poor exposure of the articular surface. Therefore, a medial epicondyle osteotomy may be needed. Current methods describe osteotomy of the medial femoral epicondyle. However, this method requires additional detachment of the [...] Read more.
The treatment of medial tibial plateau fractures can be challenging due to poor exposure of the articular surface. Therefore, a medial epicondyle osteotomy may be needed. Current methods describe osteotomy of the medial femoral epicondyle. However, this method requires additional detachment of the medial meniscus in order to ensure proper visualization. The aim of this study is to present a new technique using distal osteotomy of the superficial medial collateral ligament and to analyze the area of the exposed articular surface area. On each of eight fresh-frozen human cadaveric knees (mean age: 79.4 ± 9.4 years), an osteotomy and proximal reflection of the distal insertion of the superficial medial collateral ligament combined with a submeniscal arthrotomy was performed, followed by a medial epicondyle osteotomy. Using a three-dimensional measurement arm (Absolute Arm 8320-7, Hexagon Metrology GmbH), the exposed area was analyzed and compared to the entire medial articular surface using ANOVA (p < 0.05). Through the medial epicondyle osteotomy, 39.9 ± 9.7% of the anteromedial articular surface was seen. This area was significantly smaller compared to the osteotomy of the distal insertion of the superficial collateral ligament with an exposed articular surface of 77.2 ± 16.9% (p = 0.004). Thus, the distal osteotomy exposed 37.3% more of the articular surface compared to the medial epicondyle osteotomy. None of these techniques were able to adequately expose the posteromedial- and medial-most aspects of the tibial plateau. A distal superficial collateral ligament osteotomy may be superior to a medial epicondyle osteotomy when an extension of the anteromedial approach to the tibial plateau is required. A distal superficial medial collateral ligament osteotomy combines the advantages of better exposure of the medial articular surface with preservation of the blood supply to the medial meniscus. However, surgeons should carefully consider whether such an extended approach is necessary, as it significantly increases invasiveness. Full article
(This article belongs to the Special Issue Advanced Knee Surgery)
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Other

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7 pages, 502 KiB  
Brief Report
The Incidence Rate, Microbiological Etiology, and Results of Treatments of Prosthetic Joint Infection following Total Knee Arthroplasty
by Han-Kook Yoon, Ju-Hyung Yoo, Hyun-Cheol Oh, Joong-Won Ha and Sang-Hoon Park
J. Clin. Med. 2023, 12(18), 5908; https://doi.org/10.3390/jcm12185908 - 12 Sep 2023
Viewed by 964
Abstract
Periprosthetic joint infection (PJI) remains among the most challenging and costly complications. PJI rates vary from 0.39% to 3.9% after total knee arthroplasty (TKA). This study aimed to identify the causative microorganisms involved and to report our experience of subsequent treatment of PJI [...] Read more.
Periprosthetic joint infection (PJI) remains among the most challenging and costly complications. PJI rates vary from 0.39% to 3.9% after total knee arthroplasty (TKA). This study aimed to identify the causative microorganisms involved and to report our experience of subsequent treatment of PJI following over 7000 TKAs performed over 19 years. A retrospective study was conducted on 4547 patients (7019 cases) from March 2000 to September 2019. The incidence rate of PJI was 0.5%. Gram-positive bacteria accounted for 88.8% (n = 16) of the 18 cases, and S. aureus was the most commonly isolated pathogen (n = 7, 38.8%). There were six cases of MSSA and one case of MRSA. Streptococcus species (n = 7, 38.8%) also showed the same pattern. The CoNS species (n = 2, 11.1%) and Gram-negative bacteria (n = 1, 5.5%) were also reported. Candida species were isolated from 1 patient (5.5%). Successful I&D and implant retention (DAIR procedures) was achieved at the final follow-up in 19 patients (82.6%). The incidence of causative microorganisms was different for each PJI onset type. The overall infection rate of PJI was less than 1%. Although the success rate of DAIR procedures is lower than the two-stage exchange arthroplasty in this study, it is possible to achieve acceptable success rates if DAIR procedures are carefully selected considering the virulence of the microorganism, duration since symptom onset, and early-onset infection. Full article
(This article belongs to the Special Issue Advanced Knee Surgery)
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