Average Knee Injury And Osteoarthritis Outcome Score Research Articles

Does arthroscopic patellar denervation with high tibial osteotomy improve anterior knee pain?

PurposePatellofemoral (PF) joint osteoarthritis (OA) is a major cause of anterior knee pain. Combined PF and medial tibiofemoral (TF) OA is common in older adults. We evaluated the effect of arthroscopic patellar denervation (PD) in patients with combined TF and PFOA after malalignment correction.MethodsForty-five patients [females/males, 27/18; age, 30–59 years (45.5 ± 8.50); mean body mass index, 25.15 ± 3.04 kg/m2] were treated in our department from March 2017 to March 2019. The patients were randomised into 2 groups: group A included 22 patients who underwent open-wedge high tibial osteotomy (OWHTO) and arthroscopic PD and group B included 23 patients who underwent OWHTO without denervation. The effect of denervation was statistically and clinically evaluated using the Knee injury and Osteoarthritis Outcome Score (KOOS) and Kujala (anterior knee pain score) score.ResultsAfter 24 months, 40 patients were available for the final follow-up. The final values of KOOS and the Kujala score were significantly different between the groups (p < 0.001). For group A, the average KOOS improved from 42.73 to 72.38 (p < 0.001) and the Kujala score improved from 42 to 74.1 (p < 0.001), whereas in group B, the average KOOS improved from 39.22 to 56.84 (p < 0.001) and the Kujala score improved from 39.7 to 56.4 (p < 0.001).ConclusionAdding arthroscopic PD to OWHTO relieves anterior knee pain in patients with combined TF and PFOA and improves knee joint function and quality of life.Level of evidenceLevel I prospective randomised control clinical trial.

Treatment of posterolateral tibial plateau fractures with a rotational support plate and special pressurizer: technical note and retrospective case series

BackgroundIn tibial plateau fractures, the posterolateral segment of the tibia plateau is frequently affected and challenging to treat. Although there are many surgical approaches and fixation methods for the treatment of these fractures, all of these methods have limitations. We designed a new rotational support plate (RSP) and a special pressurizer that can fix the fracture directly via the anterolateral approach. This method is advantageous because it leads to little trauma, involves a simple operation, and has a reliable fixation effect. This study details the technique of treating these fractures with the RSP and special pressurizer and provides the outcomes.MethodsFrom May 2016 to January 2019, the data of 12 patients with posterolateral tibial plateau fractures treated with the RSP and special pressurizer in our hospital were retrospectively analyzed. Postoperative rehabilitation was advised, knee X-rays were taken at follow-ups, and fracture healing, complications, and knee range of motion were assessed. The Hospital for Special Surgery (HSS) knee score and Knee Injury and Osteoarthritis Outcome Score (KOOS) were used to evaluate knee function at the last follow-up.ResultsThe average follow-up time of all patients was 16.5 months (range, 12–25 months). The average bony union time was 3.2 months (range, 3–4.5 months). At the last follow-up, the average knee range of motion was 138° (range, 107–145°). The average HSS score was 91 (range, 64–98). The average KOOS Symptoms score was 90 (range, 75–96). The average KOOS Pain score was 91 (range, 72–97). The average KOOS ADL score was 91 (range, 74–97). The average KOOS sport/recreation score was 83 (range, 70–90). The average KOOS QOL score was 88 (range, 69–93). Skin necrosis, incision infections, and fixation failure did not occur during the follow-up period.ConclusionsWith our newly designed RSP and special pressurizer, posterolateral tibial plateau fractures can be easily and effectively reduced and fixed through the anterolateral approach, which serves as a novel treatment for posterolateral tibial plateau fractures.

Experience of radical arthroscopic removal of tenosinovial giant cell tumor of the knee joint in female military personnel

Relevance. Diffuse-type tenosynovial giant cell tumor (D-TGCT) is a relatively rare tumor of tendon sheaths and synovial membranes, but its appearance significantly impairs organ function. Currently, the pathogenesis of this disease is associated with overexpression of colony stimulating factor-1.Intention: To show the possibilities and advantages of radical resection of D-TGCT of the knee joint with arthroscopic access before traditional open surgery.Methodology. In hospital # 2 of the All-Russian Center for Emergency and Radiation Medicine named after A.M. Nikiforov, EMERCOM of Russia (St. Petersburg), two female military personnel aged 31 and 38 years underwent arthroscopic surgeries on the knee joint for radical resection of D-TGCT in 2018. Dynamic magnetic resonance imaging (MRI) and histological examination of puncture biopsy specimens were conducted preoperatively. Functionality of the knee joints was assessed before surgery and in the long term using Knee injury and osteoarthritis outcome score (KOOS), Lysholm Knee Scoring Scale (Lysholm) and visual analogue scale (VAS) and MRI control.Results and Discussion. D-TGCTs of the knee joints were removed simultaneously and radically using arthroscopic access. Histological examination of the obtained samples revealed the giant-cell diffuse-type tumors in both cases. A stable remission of the disease was obtained in the long-term period of postoperative observation. Good cosmetic surgery results have been achieved. The average KOOS, Lysholm, and VAS scores for knee function in patients were consistent with excellent and good results.Conclusion. The long-term results of surgical treatment of D-TGCT of the knee via arthroscopic access showed that the procedure can be reliable, safe and beneficial for functionality.