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Periprosthetic fractures after total knee arthroplasty may occur in any part of the femur, tibia and patella, and the most common pattern involves the supracondylar area of the distal femur. Supracondylar periprosthetic fractures frequently occur above a well-fixed prosthesis, and risk factors include anterior femoral cortical notching and use of the rotational constrained implant. Periprosthetic tibial fractures are frequently associated with loose components and malalignment or malposition of

The aim of this study was to test the clinical efficacy of TissueGene-C (TG-C), a cell and gene therapeutic for osteoarthritis consisting of non-transformed and transduced chondrocytes (3:1) retrovirally transduced to overexpress transforming growth factor-β1. A total of 163 Kellgren-Lawrence grade 3 patients with knee osteoarthritis were randomly assigned to receive intra-articular TG-C or placebo. Primary efficacy measures included criteria for subjective assessment by International Knee Docum

BACKGROUND: Numerous studies have investigated anterior stability of the knee during the anterior drawer test after anterior cruciate ligament reconstruction. Few studies have evaluated anterior cruciate ligament reconstruction under physiological loads. PURPOSE: To determine whether anterior cruciate ligament reconstruction reproduced knee motion under simulated muscle loads. STUDY DESIGN: Controlled laboratory study. METHODS: Eight human cadaveric knees were tested with the anterior cruciate l

Background: There is currently no optimal method for cartilage restoration in large, full-thickness cartilage defects in older patients. Purpose: To determine whether implantation of a composite of allogeneic umbilical cord blood–derived mesenchymal stem cells and 4% hyaluronate (UCB-MSC-HA) will result in reliable cartilage restoration in patients with large, full-thickness cartilage defects and whether any clinical improvements can be maintained up to 5 years postoperatively. Study Design: Ran

BACKGROUND: The ideal surgical treatment for complete acromioclavicular dislocation is considered to be restoring separately each ligament supporting the joint to achieve optimal clinical outcomes. HYPOTHESIS: Reconstruction of the coracoclavicular ligaments using 2 suture anchors and coracoacromial ligament transfer in patients with acromioclavicular dislocation provides reliable clinical outcomes. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Twenty-nine patients with acute acromio

ACL deficiency altered both the mediolateral tibial translation and valgus-varus rotation under various loading conditions. The increased medial tibial translation could shift the contact in the medial compartment towards the medial tibial spine, a region where degeneration is observed in ACL-deficient patients. In addition to restoring anterior laxity, ACL reconstruction might need to restore the mediolateral translation of the tibia and varus-valgus rotation of the knee.

Contemporary single bundle ACL reconstruction restores anterior tibial translation under anterior tibial load with different forces (both magnitude and orientation) in the graft compared to the intact ACL. Such graft function might alter knee kinematics in other degrees of freedom and could overly constrain the tibial rotation. An anatomic ACL reconstruction should reproduce the magnitude and orientation of the intact ACL force vector, so that the 6-degrees-of-freedom knee kinematics and joint r

BACKGROUND: The prevalence of traumatic anterior shoulder dislocation in the elderly population has increased; however, no consensus has been reached regarding the management of shoulder dislocations in elderly patients. PURPOSE: This study investigated the clinical manifestations of traumatic anterior shoulder dislocation in patients older than 60 years and evaluated the functional outcomes of different treatment modalities based on associated abnormalities and the number of dislocations. STUDY

ClinicalTrials.gov ( NCT01510535 ). This trial was registered on January 6, 2012.

PURPOSE: Tunnel widening after anterior cruciate ligament (ACL) reconstruction is a frequently described phenomenon. The possible etiology is multi-factorial with some mechanical and biological factors. Among those, we intended to determine the relation between the location and orientation of the femoral tunnel and the femoral tunnel enlargement after outside-in single-bundle ACL reconstruction. MATERIALS AND METHODS: A retrospective study including 42 patients who received single-bundle ACL rec

Purpose:Little is known about the isometry of anatomic singlebundle anterior cruciate ligament (ACL) tunnel positions in vivo although it is closely related to graft tension throughout the range of motion.The purpose of this study was to evaluate intraoperative graft isometry in anatomic single bundle ACL reconstruction in vivo.Materials and Methods: Graft length changes were assessed before bioscrew fixation in the tibial tunnel by pulling the graft with tensions of 20 lbs and 30 lbs in full ex

PURPOSE: The purpose of this study was to compare the morphologic change of the posterior cruciate ligament (PCL) on magnetic resonance imaging (MRI) in chronic anterior cruciate ligament (ACL) tear before and after reconstruction. MATERIALS AND METHODS: On the MRI image after ACL reconstruction, a base line (BL) was drawn between the femoral and tibial insertion sites of the PCL. Point A was established as the vertically farthest point from BL. Line 1 and 2 were drawn respectively between point

BACKGROUND: The purpose of this study was to compare the functional outcomes and re-dislocation rates of medial patellofemoral ligament (MPFL) reconstruction, MPFL repair, combined proximal realignment (CPR), and conservative management for primary patellar dislocation by conducting a systematic literature search of the available studies. The hypothesis was that MPFL repair and MPFL reconstruction would be better options for treating primary patellar dislocation. METHODS: Randomized controlled t