Pub Date : 2024-04-04DOI: 10.1186/s43019-024-00216-7
Zi Qiang Glen Liau, M. Ng, Shawn Shao En Low, Brian Zhaojie Chin, James Hoi Po Hui, Fareed Husain Yusuf Kagda
{"title":"A novel practical method to predict anterior cruciate ligament hamstring graft size using preoperative MRI","authors":"Zi Qiang Glen Liau, M. Ng, Shawn Shao En Low, Brian Zhaojie Chin, James Hoi Po Hui, Fareed Husain Yusuf Kagda","doi":"10.1186/s43019-024-00216-7","DOIUrl":"https://doi.org/10.1186/s43019-024-00216-7","url":null,"abstract":"","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140741323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluating the accuracy and relevance of ChatGPT responses to frequently asked questions regarding total knee replacement","authors":"Siyuan Zhang, Zi Qiang Glen Liau, Kian Loong Melvin Tan, Wei Liang Chua","doi":"10.1186/s43019-024-00218-5","DOIUrl":"https://doi.org/10.1186/s43019-024-00218-5","url":null,"abstract":"","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140751892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.1186/s43019-023-00203-4
Hyung Jun Park, Joon Hyeok Boo, Dong Hun Suh, Jae Gyoon Kim
{"title":"Analysis of radiographic factors affecting the significant differences in knee alignment between hip-to-talus and hip-to-calcaneus radiographs after opening-wedge high tibial osteotomy","authors":"Hyung Jun Park, Joon Hyeok Boo, Dong Hun Suh, Jae Gyoon Kim","doi":"10.1186/s43019-023-00203-4","DOIUrl":"https://doi.org/10.1186/s43019-023-00203-4","url":null,"abstract":"","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138608550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-25DOI: 10.1186/s43019-023-00197-z
Bo Seung Bae, Sunin Yoo, Sang Hak Lee
Ramp lesions, commonly observed in patients with anterior cruciate ligament (ACL) injuries, have been previously defined as longitudinal tears around the meniscocapsular junction. However, the definitions and interpretations of ramp lesions have varied, emphasizing the need to confirm their presence before surgery and the importance of direct visualization using arthroscopy. Recent histological studies have reported new findings on ramp lesions, shedding light on their attachment mechanisms. The anatomical structures around the ramp lesion, such as the posterior horn of medial meniscus (PHMM), semimembranosus (SM), posteromedial (PM) capsule, and meniscotibial ligament (MTL), were assessed regarding how these structures could be attached to each other. The studies of ramp lesions have also contributed to the progression of biomechanical studies explaining the cause and effects of ramp lesions. Ramp lesion has been proven to stabilize the anteroposterior (AP) instability of ACL. In addition, various laboratory studies have demonstrated the relationship between rotational instability of the knee joint and ramp lesions. The analysis of risk factors of ramp lesion helped to understand the injury mechanism of the lesion. Many authors have evaluated the prevalence of ramp lesions in patients with ACL injuries. The development of arthroscopy techniques has influenced the outcomes of ACL reconstruction with the easy detection of ramp lesions. This review article aims to analyze the past findings and recent advancements in anatomical, biomechanical, and epidemiological studies of ramp lesions in patients who underwent ACL reconstruction, and provide various perspectives ramp lesions in patients with ACL reconstruction.
{"title":"Ramp lesion in anterior cruciate ligament injury: a review of the anatomy, biomechanics, epidemiology, and diagnosis.","authors":"Bo Seung Bae, Sunin Yoo, Sang Hak Lee","doi":"10.1186/s43019-023-00197-z","DOIUrl":"10.1186/s43019-023-00197-z","url":null,"abstract":"<p><p>Ramp lesions, commonly observed in patients with anterior cruciate ligament (ACL) injuries, have been previously defined as longitudinal tears around the meniscocapsular junction. However, the definitions and interpretations of ramp lesions have varied, emphasizing the need to confirm their presence before surgery and the importance of direct visualization using arthroscopy. Recent histological studies have reported new findings on ramp lesions, shedding light on their attachment mechanisms. The anatomical structures around the ramp lesion, such as the posterior horn of medial meniscus (PHMM), semimembranosus (SM), posteromedial (PM) capsule, and meniscotibial ligament (MTL), were assessed regarding how these structures could be attached to each other. The studies of ramp lesions have also contributed to the progression of biomechanical studies explaining the cause and effects of ramp lesions. Ramp lesion has been proven to stabilize the anteroposterior (AP) instability of ACL. In addition, various laboratory studies have demonstrated the relationship between rotational instability of the knee joint and ramp lesions. The analysis of risk factors of ramp lesion helped to understand the injury mechanism of the lesion. Many authors have evaluated the prevalence of ramp lesions in patients with ACL injuries. The development of arthroscopy techniques has influenced the outcomes of ACL reconstruction with the easy detection of ramp lesions. This review article aims to analyze the past findings and recent advancements in anatomical, biomechanical, and epidemiological studies of ramp lesions in patients who underwent ACL reconstruction, and provide various perspectives ramp lesions in patients with ACL reconstruction.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10464050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10492539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-02DOI: 10.1186/s43019-023-00196-0
Nikit Venishetty, Dane K Wukich, Jack Beale, J Riley Martinez, Michel Toutoungy, Varatharaj Mounasamy, Senthil Sambandam
Background: Chronic kidney disease (CKD) is a growing disease that affects millions of people in the USA every year. Many CKD patients progress to end-stage renal disease (ESRD), necessitating the use of hemodialysis to alleviate symptoms and manage kidney function. Furthermore, many of these patients have lower bone quality and experience more postoperative complications. However, there is currently limited information on hospitalization information and perioperative complications in this population following procedures such as total knee arthroplasty (TKA). The purpose of this study was to assess the patient characteristics, demographics, and prevalence of postoperative problems among dialysis patients who received TKA.
Methods: In this retrospective study, we used the Nationwide Inpatient Sample (NIS) data from 2016 to 2019 to analyze the incidence of perioperative complications, length of stay (LOS), and the cost of care (COC) among patients undergoing TKA who were categorized as dialysis patients, compared with those who were not. Propensity matching was conducted to consider associated factors that may influence perioperative complications.
Results: From 2016 to 2019, 558,371 patients underwent TKAs, according to the National In-Sample (NIS) database. Of those, 418 patients (0.1%) were in the dialysis group, while the remaining 557,953 patients were included in the control group. The mean age of the dialysis group was 65.4 ± 9.8 years, and the mean age in the control group was 66.7 ± 9.5 years (p = 0.006). After propensity matching, dialysis group patients had a higher risk of receiving blood transfusions [odds ratio (OR): 2; 95% confidence interval (CI): 1.2, 3.4] and a significantly larger COC in comparison to those in the control group (91,434.3 USD versus 71,943.6 USD, p < 0.001). In addition, dialysis patients had significantly higher discharges to another facility, as compared with the control group patients.
Conclusions: The dialysis group had a significantly higher cost of care, higher rates of requiring blood transfusion, and more cases of being discharged to another facility than non-dialysis patients. This data will help providers make informed decisions about patient care and resource allocation for dialysis patients undergoing TKA.
{"title":"Total knee arthroplasty in dialysis patients: a national in-patient sample-based study of perioperative complications.","authors":"Nikit Venishetty, Dane K Wukich, Jack Beale, J Riley Martinez, Michel Toutoungy, Varatharaj Mounasamy, Senthil Sambandam","doi":"10.1186/s43019-023-00196-0","DOIUrl":"https://doi.org/10.1186/s43019-023-00196-0","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a growing disease that affects millions of people in the USA every year. Many CKD patients progress to end-stage renal disease (ESRD), necessitating the use of hemodialysis to alleviate symptoms and manage kidney function. Furthermore, many of these patients have lower bone quality and experience more postoperative complications. However, there is currently limited information on hospitalization information and perioperative complications in this population following procedures such as total knee arthroplasty (TKA). The purpose of this study was to assess the patient characteristics, demographics, and prevalence of postoperative problems among dialysis patients who received TKA.</p><p><strong>Methods: </strong>In this retrospective study, we used the Nationwide Inpatient Sample (NIS) data from 2016 to 2019 to analyze the incidence of perioperative complications, length of stay (LOS), and the cost of care (COC) among patients undergoing TKA who were categorized as dialysis patients, compared with those who were not. Propensity matching was conducted to consider associated factors that may influence perioperative complications.</p><p><strong>Results: </strong>From 2016 to 2019, 558,371 patients underwent TKAs, according to the National In-Sample (NIS) database. Of those, 418 patients (0.1%) were in the dialysis group, while the remaining 557,953 patients were included in the control group. The mean age of the dialysis group was 65.4 ± 9.8 years, and the mean age in the control group was 66.7 ± 9.5 years (p = 0.006). After propensity matching, dialysis group patients had a higher risk of receiving blood transfusions [odds ratio (OR): 2; 95% confidence interval (CI): 1.2, 3.4] and a significantly larger COC in comparison to those in the control group (91,434.3 USD versus 71,943.6 USD, p < 0.001). In addition, dialysis patients had significantly higher discharges to another facility, as compared with the control group patients.</p><p><strong>Conclusions: </strong>The dialysis group had a significantly higher cost of care, higher rates of requiring blood transfusion, and more cases of being discharged to another facility than non-dialysis patients. This data will help providers make informed decisions about patient care and resource allocation for dialysis patients undergoing TKA.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10394770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10295121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-26DOI: 10.1186/s43019-023-00195-1
Kyle W Lawrence, Walter Sobba, Vinaya Rajahraman, Ran Schwarzkopf, Joshua C Rozell
Purpose: The study aimed to determine whether body mass index (BMI) classification for patients undergoing total knee arthroplasty (TKA) is associated with differences in mean patient reported outcome measure (PROM) score improvements across multiple domains-including pain, functional status, mental health, and global physical health. We hypothesized that patients with larger BMIs would have worse preoperative and postoperative PROM scores, though improvements in scores would be comparable between groups.
Materials and methods: Patients undergoing primary TKA from 2018 to 2021 were retrospectively reviewed and stratified into four groups: Normal Weight; 18.5-25 kg/m2, Overweight; 25.01-30 kg/m2, Obese; 30.01-40 kg/m2, and Morbidly Obese > 40 kg/m2. Preoperative, postoperative, and pre/post-changes (Δ) in knee injury and osteoarthritis, joint replacement (KOOS, JR) and Patient-Reported Outcome Measurement Information System (PROMIS) measures of pain intensity, pain interference, physical function, mobility, mental health, and physical health were compared. Multivariate linear regression was used to assess for confounding comorbid conditions.
Results: In univariate analysis, patients with larger BMIs had worse scores for KOOS, JR and all PROMIS metrics preoperatively. Postoperatively, scores for KOOS, JR and PROMIS pain interference, mobility, and physical health were statistically worse in higher BMI groups, though differences were not clinically significant. Morbidly obese patients achieved greater pre/post-Δ improvements in KOOS, JR and global physical health scores. Multivariate regression analysis showed high BMI was independently associated with greater pre/post-Δ improvements in KOOS, JR and global health scores.
Conclusion: Obese patients report worse preoperative scores for function and health, but greater pre/post-Δ improvements in KOOS, JR and physical health scores following TKA. Quality of life benefits of TKA in obese patients should be a factor when assessing surgical candidacy.
{"title":"Does body mass index influence improvement in patient reported outcomes following total knee arthroplasty? A retrospective analysis of 3918 cases.","authors":"Kyle W Lawrence, Walter Sobba, Vinaya Rajahraman, Ran Schwarzkopf, Joshua C Rozell","doi":"10.1186/s43019-023-00195-1","DOIUrl":"https://doi.org/10.1186/s43019-023-00195-1","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to determine whether body mass index (BMI) classification for patients undergoing total knee arthroplasty (TKA) is associated with differences in mean patient reported outcome measure (PROM) score improvements across multiple domains-including pain, functional status, mental health, and global physical health. We hypothesized that patients with larger BMIs would have worse preoperative and postoperative PROM scores, though improvements in scores would be comparable between groups.</p><p><strong>Materials and methods: </strong>Patients undergoing primary TKA from 2018 to 2021 were retrospectively reviewed and stratified into four groups: Normal Weight; 18.5-25 kg/m<sup>2</sup>, Overweight; 25.01-30 kg/m<sup>2</sup>, Obese; 30.01-40 kg/m<sup>2</sup>, and Morbidly Obese > 40 kg/m<sup>2</sup>. Preoperative, postoperative, and pre/post-changes (Δ) in knee injury and osteoarthritis, joint replacement (KOOS, JR) and Patient-Reported Outcome Measurement Information System (PROMIS) measures of pain intensity, pain interference, physical function, mobility, mental health, and physical health were compared. Multivariate linear regression was used to assess for confounding comorbid conditions.</p><p><strong>Results: </strong>In univariate analysis, patients with larger BMIs had worse scores for KOOS, JR and all PROMIS metrics preoperatively. Postoperatively, scores for KOOS, JR and PROMIS pain interference, mobility, and physical health were statistically worse in higher BMI groups, though differences were not clinically significant. Morbidly obese patients achieved greater pre/post-Δ improvements in KOOS, JR and global physical health scores. Multivariate regression analysis showed high BMI was independently associated with greater pre/post-Δ improvements in KOOS, JR and global health scores.</p><p><strong>Conclusion: </strong>Obese patients report worse preoperative scores for function and health, but greater pre/post-Δ improvements in KOOS, JR and physical health scores following TKA. Quality of life benefits of TKA in obese patients should be a factor when assessing surgical candidacy.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10373362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9940980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-17DOI: 10.1186/s43019-023-00193-3
Dhruv S Shankar, Amanda Avila, Brittany DeClouette, Kinjal D Vasavada, Isabella B Jazrawi, Michael J Alaia, Guillem Gonzalez-Lomas, Eric J Strauss, Kirk A Campbell
Background: The purpose of this study was to identify socioeconomic predictors of time to initial evaluation, time to surgery, and postoperative outcomes among lateral patellar instability patients undergoing medial patellofemoral ligament reconstruction (MPFLR).
Methods: We conducted a retrospective review of patients at our institution who underwent primary MPFLR with allograft from 2011 to 2019 and had minimum 12-month follow-up. Patients were administered an email survey in January 2022 to assess symptom history, socioeconomic status, and postoperative outcomes including VAS satisfaction and Kujala score. Predictors of time to initial evaluation, time to surgery, and postoperative outcomes were identified using multivariable linear and logistic regression with stepwise selection.
Results: Seventy patients were included in the cohort (mean age 24.8 years, 72.9% female, mean follow-up time 45.7 months). Mean time to evaluation was 6.4 months (range 0-221) and mean time to surgery was 73.6 months (range 0-444). Having a general health check-up in the year prior to surgery was predictive of shorter time to initial evaluation (β = - 100.5 [- 174.5, - 26.5], p = 0.008). Home ownership was predictive of shorter time to surgery (β = - 56.5 [- 104.7, 8.3], p = 0.02). Full-time employment was predictive of higher VAS satisfaction (β = 14.1 [4.3, 23.9], p = 0.006) and higher Kujala score (β = 8.7 [0.9, 16.5], p = 0.03).
Conclusion: Markers of higher socioeconomic status including having a general check-up in the year prior to surgery, home ownership, and full-time employment were predictive of shorter time to initial evaluation, shorter time to surgery, and superior postoperative outcomes.
Level of evidence: IV, retrospective case series.
背景:本研究的目的是确定接受内侧髌股韧带重建(MPFLR)的外侧髌骨不稳患者的初始评估时间、手术时间和术后结果的社会经济预测因素。方法:我们对2011年至2019年在我院接受同种异体移植的原发性MPFLR患者进行了回顾性研究,并进行了至少12个月的随访。于2022年1月对患者进行电子邮件调查,以评估症状史、社会经济状况和术后结果,包括VAS满意度和Kujala评分。使用逐步选择的多变量线性和逻辑回归确定初始评估时间、手术时间和术后结果的预测因子。结果:70例患者纳入队列,平均年龄24.8岁,女性72.9%,平均随访时间45.7个月。平均评估时间6.4个月(范围0-221),平均手术时间73.6个月(范围0-444)。在手术前一年进行全面健康检查可预示较短的初始评估时间(β = - 100.5 [- 174.5, - 26.5], p = 0.008)。房屋所有权预测手术时间较短(β = - 56.5 [- 104.7, 8.3], p = 0.02)。全职工作可预测较高的VAS满意度(β = 14.1 [4.3, 23.9], p = 0.006)和较高的Kujala评分(β = 8.7 [0.9, 16.5], p = 0.03)。结论:较高的社会经济地位的标志,包括术前一年的一般检查,房屋所有权和全职工作,预示着较短的初始评估时间,较短的手术时间和较好的术后结果。证据等级:IV级,回顾性病例系列。
{"title":"Home ownership, full-time employment, and other markers of higher socioeconomic status are predictive of shorter time to initial evaluation, shorter time to surgery, and superior postoperative outcomes among lateral patellar instability patients undergoing medial patellofemoral ligament reconstruction.","authors":"Dhruv S Shankar, Amanda Avila, Brittany DeClouette, Kinjal D Vasavada, Isabella B Jazrawi, Michael J Alaia, Guillem Gonzalez-Lomas, Eric J Strauss, Kirk A Campbell","doi":"10.1186/s43019-023-00193-3","DOIUrl":"https://doi.org/10.1186/s43019-023-00193-3","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to identify socioeconomic predictors of time to initial evaluation, time to surgery, and postoperative outcomes among lateral patellar instability patients undergoing medial patellofemoral ligament reconstruction (MPFLR).</p><p><strong>Methods: </strong>We conducted a retrospective review of patients at our institution who underwent primary MPFLR with allograft from 2011 to 2019 and had minimum 12-month follow-up. Patients were administered an email survey in January 2022 to assess symptom history, socioeconomic status, and postoperative outcomes including VAS satisfaction and Kujala score. Predictors of time to initial evaluation, time to surgery, and postoperative outcomes were identified using multivariable linear and logistic regression with stepwise selection.</p><p><strong>Results: </strong>Seventy patients were included in the cohort (mean age 24.8 years, 72.9% female, mean follow-up time 45.7 months). Mean time to evaluation was 6.4 months (range 0-221) and mean time to surgery was 73.6 months (range 0-444). Having a general health check-up in the year prior to surgery was predictive of shorter time to initial evaluation (β = - 100.5 [- 174.5, - 26.5], p = 0.008). Home ownership was predictive of shorter time to surgery (β = - 56.5 [- 104.7, 8.3], p = 0.02). Full-time employment was predictive of higher VAS satisfaction (β = 14.1 [4.3, 23.9], p = 0.006) and higher Kujala score (β = 8.7 [0.9, 16.5], p = 0.03).</p><p><strong>Conclusion: </strong>Markers of higher socioeconomic status including having a general check-up in the year prior to surgery, home ownership, and full-time employment were predictive of shorter time to initial evaluation, shorter time to surgery, and superior postoperative outcomes.</p><p><strong>Level of evidence: </strong> IV, retrospective case series.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10353107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9833631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-11DOI: 10.1186/s43019-023-00194-2
Ville T Ponkilainen, Mikko Uimonen, Raine Sihvonen, Nikke Partio, Juha Paloneva, Ville M Mattila
Background: Recent evidence has led to guidelines to refrain from recommending knee arthroscopy for patients with an osteoarthritis diagnosis. The aim of this study was to evaluate the latest changes in the incidence of arthroscopic surgery for degenerative knee disease, changes in the ages of those patients and the delay between knee arthroscopy and arthroplasty, in Finland between 1998 and 2018.
Method: The data for were collected from the Finnish National Hospital Discharge Register (NHDR). All knee arthroplasties and arthroscopies performed due to osteoarthritis, degenerative meniscal tears, and traumatic meniscal tears were included. Incidence rates (per 100,000 person-years) as well as the median age of patients were calculated.
Results: The incidence of arthroscopy decreased 74% (413 to 106 per 100,000 person-years) and knee arthroplasty increased 179% (94 to 262 per 100,000 person-years) between 1998 and 2018. The incidence of all arthroscopies increased until 2006. Subsequently, the incidence of arthroscopy due to OA decreased by 91% and arthroscopic partial meniscectomy (APM) for degenerative meniscal tears decreased by 77% until 2018. The decrease of traumatic meniscal tears begun later, leading to decrease of 57% between 2011 and 2018. Conversely, the incidence of patients undergoing APM of traumatic meniscal tear increased 375%. The median age of patients who underwent knee arthroscopy decreased from 51 to 46 and from 71 to 69 in knee arthroplasty patients.
Conclusions: Increasing evidence that recommends refraining from knee arthroscopy in OA and degenerative meniscal tears has led to a dramatic decrease in the incidence of arthroscopies. Simultaneously, the median age of the patients who undergo these operations has continued to decrease.
{"title":"Evaluation of the changes in incidence and patient age of knee arthroscopy along with changes in time between knee arthroscopy and arthroplasty between 1998 and 2018: a nationwide register study.","authors":"Ville T Ponkilainen, Mikko Uimonen, Raine Sihvonen, Nikke Partio, Juha Paloneva, Ville M Mattila","doi":"10.1186/s43019-023-00194-2","DOIUrl":"https://doi.org/10.1186/s43019-023-00194-2","url":null,"abstract":"<p><strong>Background: </strong>Recent evidence has led to guidelines to refrain from recommending knee arthroscopy for patients with an osteoarthritis diagnosis. The aim of this study was to evaluate the latest changes in the incidence of arthroscopic surgery for degenerative knee disease, changes in the ages of those patients and the delay between knee arthroscopy and arthroplasty, in Finland between 1998 and 2018.</p><p><strong>Method: </strong>The data for were collected from the Finnish National Hospital Discharge Register (NHDR). All knee arthroplasties and arthroscopies performed due to osteoarthritis, degenerative meniscal tears, and traumatic meniscal tears were included. Incidence rates (per 100,000 person-years) as well as the median age of patients were calculated.</p><p><strong>Results: </strong>The incidence of arthroscopy decreased 74% (413 to 106 per 100,000 person-years) and knee arthroplasty increased 179% (94 to 262 per 100,000 person-years) between 1998 and 2018. The incidence of all arthroscopies increased until 2006. Subsequently, the incidence of arthroscopy due to OA decreased by 91% and arthroscopic partial meniscectomy (APM) for degenerative meniscal tears decreased by 77% until 2018. The decrease of traumatic meniscal tears begun later, leading to decrease of 57% between 2011 and 2018. Conversely, the incidence of patients undergoing APM of traumatic meniscal tear increased 375%. The median age of patients who underwent knee arthroscopy decreased from 51 to 46 and from 71 to 69 in knee arthroplasty patients.</p><p><strong>Conclusions: </strong>Increasing evidence that recommends refraining from knee arthroscopy in OA and degenerative meniscal tears has led to a dramatic decrease in the incidence of arthroscopies. Simultaneously, the median age of the patients who undergo these operations has continued to decrease.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10334544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9804771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: This study sought to clarify treatment evidence to treat patellar dislocation by evaluating which treatment could yield better improvement of clinical outcomes for acute patellar dislocation in children and adolescents 18 years of age or younger.
Materials and methods: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials electronic databases were searched for relevant articles comparing clinical outcomes of conservative and surgical treatments for acute patellar dislocation in children and adolescents published from March 2008 to August 2022. Data searching, extraction, analysis, and quality assessment were performed on the basis of the Cochrane Collaboration guidelines. The quality assessment of each study was investigated using the Physiotherapy Evidence Database (PEDro) critical appraisal scoring system and Newcastle-Ottawa Quality Assessment Scale scores. To calculate the overall combined effect size for each outcome, Review Manager Version 5.3 (The Cochrane Collaboration, Software Update, Oxford) was employed.
Results: Three randomized controlled trials (RCTs) and one prospective study were investigated. In terms of pain [mean difference (MD) 6.59, 95% confidence interval (CI) 1.73-11.45, I2 0%], there were significantly better outcomes in conservative group. Nevertheless, there were no significant differences in any evaluated outcomes such as redislocation [risk ratio (RR) 1.36, 95% CI 0.72-2.54, I2 65%], Kujala score (MD 3.92, 95% CI -0.17 to 8.01, I2 0%), Tegner score (MD 1.04, 95% CI -0.04 to 2.11, I2 71%), or subjective results (RR 0.99, 95% CI 0.74-1.34, I2 33%) between conservative and surgical treatment groups.
Conclusions: Despite better pain outcomes with conservative group, the present study revealed no significant differences in clinical outcomes between conservative treatment and surgical treatment in children and adolescents with acute patellar dislocation. Since there are no significant differences in clinical outcomes between the two groups, routine surgical treatment is not advocated for treating acute patellar dislocation in children and adolescents.
目的:本研究旨在通过评估哪种治疗方法能更好地改善18岁或以下儿童和青少年急性髌骨脱位的临床结果,来阐明治疗髌骨脱位的治疗证据。材料和方法:检索MEDLINE、EMBASE和Cochrane中央对照试验注册电子数据库,检索2008年3月至2022年8月发表的比较儿童和青少年急性髌骨脱位保守治疗和手术治疗临床结果的相关文章。根据Cochrane协作指南进行数据检索、提取、分析和质量评估。采用物理治疗证据数据库(PEDro)关键评价评分系统和纽卡斯尔-渥太华质量评估量表评分对每项研究进行质量评估。为了计算每个结果的总体综合效应大小,使用Review Manager Version 5.3 (the Cochrane Collaboration, Software Update, Oxford)。结果:共纳入3项随机对照试验(rct)和1项前瞻性研究。在疼痛方面[平均差异(MD) 6.59, 95%可信区间(CI) 1.73 ~ 11.45, I2 %],保守组明显优于保守组。然而,保守治疗组和手术治疗组在复位[风险比(RR) 1.36, 95% CI 0.72-2.54, I2 65%]、Kujala评分(MD 3.92, 95% CI -0.17 - 8.01, I2 0%)、Tegner评分(MD 1.04, 95% CI -0.04 - 2.11, I2 71%)或主观结果(RR 0.99, 95% CI 0.74-1.34, I2 33%)等任何评估结果上均无显著差异。结论:尽管保守治疗组疼痛预后较好,但本研究显示,儿童和青少年急性髌骨脱位保守治疗与手术治疗的临床结果无显著差异。由于两组临床结果无显著差异,不提倡常规手术治疗儿童及青少年急性髌骨脱位。
{"title":"A systematic review and meta-analysis comparing conservative and surgical treatments for acute patellar dislocation in children and adolescents.","authors":"Dong-Yeong Lee, Dong-Geun Kang, Ho-Seung Jo, Se-Joon Heo, Ji-Ho Bae, Sun-Chul Hwang","doi":"10.1186/s43019-023-00189-z","DOIUrl":"https://doi.org/10.1186/s43019-023-00189-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study sought to clarify treatment evidence to treat patellar dislocation by evaluating which treatment could yield better improvement of clinical outcomes for acute patellar dislocation in children and adolescents 18 years of age or younger.</p><p><strong>Materials and methods: </strong>MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials electronic databases were searched for relevant articles comparing clinical outcomes of conservative and surgical treatments for acute patellar dislocation in children and adolescents published from March 2008 to August 2022. Data searching, extraction, analysis, and quality assessment were performed on the basis of the Cochrane Collaboration guidelines. The quality assessment of each study was investigated using the Physiotherapy Evidence Database (PEDro) critical appraisal scoring system and Newcastle-Ottawa Quality Assessment Scale scores. To calculate the overall combined effect size for each outcome, Review Manager Version 5.3 (The Cochrane Collaboration, Software Update, Oxford) was employed.</p><p><strong>Results: </strong>Three randomized controlled trials (RCTs) and one prospective study were investigated. In terms of pain [mean difference (MD) 6.59, 95% confidence interval (CI) 1.73-11.45, I<sup>2</sup> 0%], there were significantly better outcomes in conservative group. Nevertheless, there were no significant differences in any evaluated outcomes such as redislocation [risk ratio (RR) 1.36, 95% CI 0.72-2.54, I<sup>2</sup> 65%], Kujala score (MD 3.92, 95% CI -0.17 to 8.01, I<sup>2</sup> 0%), Tegner score (MD 1.04, 95% CI -0.04 to 2.11, I<sup>2</sup> 71%), or subjective results (RR 0.99, 95% CI 0.74-1.34, I<sup>2</sup> 33%) between conservative and surgical treatment groups.</p><p><strong>Conclusions: </strong>Despite better pain outcomes with conservative group, the present study revealed no significant differences in clinical outcomes between conservative treatment and surgical treatment in children and adolescents with acute patellar dislocation. Since there are no significant differences in clinical outcomes between the two groups, routine surgical treatment is not advocated for treating acute patellar dislocation in children and adolescents.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10286373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9709864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}