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The purpose of the study was to investigate the long-term outcomes of the all-inside arthroscopic medial reefing (AAMR) procedure for patellar instability and the factors that affect successful outcome.<br /><br /> In this retrospective study, AAMR with suture was performed in 16 knees of 15 patients who had at least one patellar dislocation and did not experience a decrease in pain and who did not have a major radiological bony abnormality. Preoperatively, Tegner and Lysholm scales were used; for the final evaluation Tegner, Lysholm, Kujala and Knee injury and Osteoarthritis Outcome Score (KOOS) were used.<br /><br /> The average age of the patients at the time of operation was 18years (range 11-36years). The average follow-up time was 118.3months (range 85-143months). Six of the 16 knees (37.5%) exhibited re-dislocation. Preoperatively, the mean Lysholm and Tegner were 66.5 and 4.0, respectively; and postoperatively increased to 89.3 (P=.001) and 4.66, respectively. At the final follow-up, mean Kujala was 89.3 (good), and mean KOOS was 91.4. In all patients with re-dislocation, fewer than four knots were used, and none of the patients with four knots exhibited re-dislocation. Re-dislocations occurred in two, two, one and one patients at two, three, five and eight years, respectively.<br /><br /> The AAMR technique is associated with minimal incisional scarring and an increase in functional scores. It is also associated with a high risk of re-dislocation compared with other methods. If the technique still needs to be used, despite the high re-dislocation rate, at least four knots should be applied.<br /><br />The AAMR technique is associated with minimal incisional scarring and an increase in functional scores. It is also associated with a high risk of re-dislocation compared with other methods. If the technique still needs to be used, despite the high re-dislocation rate, at least four knots should be applied.<br /><br /> Increasing demand for total knee arthroplasties (TKA) has been targeted by legislation to minimize costs and maximize outcomes. Home discharges reduce costs, and it is important to determine patient variables associated with this discharge disposition. We explored non-modifiable and modifiable factors associated with non-home discharges to determine what patient specific factors require attention.<br /><br /> This retrospective study included 171,903 National Surgical Quality Improvement Program (NSQIP) patients between 2011 and 2016. Patient specific variables and discharge destinations included home, short-term nursing facilities (SNF), not home, and rehabilitation. Chi-squared analyses and analyses of variance (ANOVA) were conducted for categorical and continuous data, respectively. Multinomial regression model was utilized to assess associations between discharge destination and patient specific variables.<br /><br /> Every year increase above the mean age (66 years) was associated with a nine percent (p &lt; .001) and six percent (p &lt; .001) increased odds for discharge to SNF or rehabilitation, respectively, compared to home discharges. Every 10% increase in BMI from the mean was associated with a 10% increase in discharge to both SNF and rehabilitation (p &lt; .001 for both).<br /><br /> With increasing demands for TKAs and expenditures to Medicare, evaluating factors that impact patient discharge can help optimize costs and outcomes of TKA procedures. Arthroplasty surgeons can benefit by recognizing these correlations and exploring reductions to non-home discharges through pre-operative patient optimization. Future studies should evaluate the economic cost potential associated with optimizing routine home discharge in TKA patients.<br /><br /> IV.<br /><br />IV.<br /><br /> The aim of the present study was to confirm the effectiveness of adding nanohydroxyapatite (NHA) to a heterologous bone graft in open-wedge high tibial osteotomy (OWHTO) by measuring the bone density via multislice computed tomography (CT) of the tibial osteotomy gap in a mid-term follow-up (five years).<br /><br /> Twenty-six patients undergoing OWHTO were randomly assigned to two groups a pure graft group (Group A), in which the osteotomy gap was filled with only heterologous bone graft, and an NHA group (Group B), in which the osteotomy gap was filled with heterologous bone graft and NHA. CT was performed within one week of the operation, after two months, after 12months and after five years. CT volume acquired in Hounsfield units (HU) was measured on three planes.<br /><br /> The normal bone density was 110.2±11.7HU. The value of mean density at five years in Group A was 296.8±81.8HU, while in Group B, it was 202.2±45.1HU, showing a density more similar to normal bone and greater bone uniformity inside the osteotomy. The difference between the two groups was statistically significant (p&lt;0.05). [https://www.selleckchem.com/products/sel120.html SEL120-34A ic50] Furthermore, both groups showed excellent mid-term clinical outcomes without significant differences.<br /><br /> This study revealed that absorbability and bone formation at the osteotomy site in the NHA group was significantly higher as compared with the pure graft group at five years postoperatively.<br /><br />This study revealed that absorbability and bone formation at the osteotomy site in the NHA group was significantly higher as compared with the pure graft group at five years postoperatively.<br /><br /> Deepening trochleoplasty has become a part of surgical management in patients with patellar instability and severe trochlear dysplasia. In addition, increased femoral antetorsion is treated most commonly by proximal femoral external rotation osteotomy.<br /><br /> Deepening trochleoplasty and supracondylar femoral external rotation osteotomy in combination improve patellar stability and function in patients presenting with recurrent patellar instability due to trochlear dysplasia and increased femoral antetorsion.<br /><br /> Therapeutic case series; Level IV.<br /><br /> Combined deepening trochleoplasty and supracondylar external rotation osteotomy were performed in seven female patients (nine knees) with recurrent patellar instability. Trochlear dysplasia (Dejour classification) and increased femoral antetorsion (Murphy computed tomography (CT)-based measurement) were documented using magnetic resonance imaging and CT scans. Data were collected prospectively preoperatively, at 12months, and at final follow-up. Complete data were avaiof deepening trochleoplasty and supracondylar external rotation osteotomy performed in one step is an individually adapted surgical procedure for restoring both horizontal limb alignment and trochlear geometry. It improves patellar stability and yields good subjective and objective functional results in most cases. link2 The condition of the cartilage at the time of surgery is crucial for the outcome with respect to the pain.<br /><br />The combination of deepening trochleoplasty and supracondylar external rotation osteotomy performed in one step is an individually adapted surgical procedure for restoring both horizontal limb alignment and trochlear geometry. link3 It improves patellar stability and yields good subjective and objective functional results in most cases. The condition of the cartilage at the time of surgery is crucial for the outcome with respect to the pain.<br /><br /> Injury to the infra-patellar branches of the saphenous nerve (IPBSN) is the main neurological complication of anterior cruciate ligament (ACL) reconstruction procedures. Surgical technique using quadriceps tendon (QT) autograft allows a less invasive tibial approach potentially protecting the IPBSN. The aim of this study was to compare the numbness surface of the cutaneous area supplied by the IPBSN after ACL reconstruction using either hamstring tendon (HT) or QT autografts.<br /><br /> This was a retrospective comparative cohort study including 51 patients who underwent ACL reconstruction (27 QT and 24 HT) between January 2017 and April 2018. A sensory clinical evaluation was performed on each patient length of the tibial scar, eventual numbness surface area and the type of sensory disorder were reported. To be considered as an IPBSN lesion, the numbness area had to spread at least one-centimeter away from the scar.<br /><br /> The average follow-up was 15months. In the HT group, the numbness area surface measured 21.2±19cm<br /><br /> (0-77) and the scar length was on average 31.3±5.6mm. In the QT group, the numbness area was reduced to 5±10cm<br /><br /> (P=.0007) as well as the scar length (13.3±2.8mm, P&lt;.0001). We counted five (17.8%) and 19 (76%) real IPBSN lesions in the QT and HT groups, respectively (P=.0002). Hypoesthesia was the main sensory disorder observed (87.5%).<br /><br /> Numbness area of the cutaneous surface supplied by the IPBSN after ACL reconstruction is reduced using QT autograft compared with HT autograft.<br /><br />Numbness area of the cutaneous surface supplied by the IPBSN after ACL reconstruction is reduced using QT autograft compared with HT autograft.<br /><br /> The reoperation rate after primary meniscal repair is about 20%. Thus far, it has remained unclear whether there are distinct individual preconditions that may be associated with a better or worse outcome of this procedure. We therefore analysed typical biochemical mediators in the synovial fluid (SF) of patients with meniscus tear before arthroscopic meniscal refixation and correlated their concentrations to the occurrence of re-rupture after meniscus repair.<br /><br /> In this study, 48 patients with meniscus ruptures were included. SF samples were taken intraoperatively prior to arthroscopy. Multiplex enzyme-linked immunosorbent assay (ELISA)-based methods were used to measure hepatocyte growth factor (HGF), interleukin-18 (IL-18), matrix metalloproteinases (MMP) MMP-1, MMP-2, MMP-9 and MMP-13 in the SF. At follow-up, the patients were classified into two groups surgical success and surgical failure.<br /><br /> Ten out of 48 patients (20.8%) had to undergo revision surgery after meniscal repair (surgical failure). The median HGF in the surgical failure group was 2.4-times higher than in the surgical success group (P=.006), and the median MMP-2 was 1.8 times higher (P=.017). Concentration levels of the other tested proteins were not correlated with the success or failure of the meniscus surgery. There was weak evidence that both markers are indicators of an unsatisfactory healing process for meniscal refixation.<br /><br /> These results suggest that HGF and MMP-2 could serve as molecular markers to estimate the chances of healing success of meniscus repair and possibly to individualise therapy in meniscal surgery.<br /><br />These results suggest that HGF and MMP-2 could serve as molecular markers to estimate the chances of healing success of meniscus repair and possibly to individualise therapy in meniscal surgery.<br /><br /> The purpose of the study was to evaluate lateral and patellofemoral osteoarthritis (OA) progression after medial unicompartmental knee arthroplasty (UKA) and identify factors affecting the progression that were not identified previously.<br /><br /> We evaluated 146 patients who underwent medial UKA between 2009 and 2014. Kellgren-Lawrence grading of lateral and patellofemoral OA was performed on preoperative and final follow-up knee radiographs. Radiographic and clinical characteristics, SF-36, and Oxford knee scores were compared between the OA progressed and non-progressed groups. Risk factors for lateral and patellofemoral OA progression were evaluated.<br /><br /> The lateral OA progressed and non-progressed groups significantly differed in side, preoperative flexion contracture, preoperative joint line convergence angle, postoperative tibiofemoral angle, insert size, revision status (P&lt;0.05), and the patellofemoral OA progressed and non-progressed groups significantly differed in age, pre- and postoperative flexion contracture, postoperative tibiofemoral angle and pre- and postoperative patellofemoral OA grade (P&lt;0.