Kinematic alignment preserves the mid-flexion trochlear line orientation in total knee arthroplasty: A prospective analysis from the FP-UCBM Knee Study Group.

Purpose: Kinematic alignment (KA) in total knee arthroplasty (TKA) aims to restore the patient's native joint anatomy by resurfacing the distal and posterior femoral condyles. However, the trochlear anatomy is often overlooked, raising concerns about potential relative internal rotation of the femoral component. The aim of this study was to define the 𠄈mid-flexion trochlear line' (MTL) and assess its orientation relative to the posterior condylar line, hypothesising a parallelism between the two.

Bisphosphonate use in patients undergoing total knee arthroplasty reduces overall and aseptic revisions and periprosthetic bone mineral density loss: A systematic review from the FP-UCBM Knee Study Group.

Purpose: Bisphosphonates (BPs), widely used for osteoporosis management, have garnered attention in the context of total knee arthroplasty (TKA) for their potential to preserve periprosthetic bone mineral density (BMD) and mitigate risks such as aseptic loosening, periprosthetic fractures, and implant failure. This study systematically reviewed the current literature on the topic, hypothesising that BP therapy reduces the risk of postoperative adverse outcomes in patients undergoing TKA.

Methods: A systematic literature search was conducted on 1 December 2024 using PubMed, Cochrane Library, Scopus and Google Scholar.

The 'over-the-top' technique allows for accurate and reproducible restoration of the native tibial slope in kinematically aligned total knee arthroplasty: A retrospective comparative analysis from the FP-UCBM Knee Study Group.

Purpose: A critical challenge in kinematically aligned total knee arthroplasty (KA TKA) is achieving accurate sagittal alignment of the tibial component. Correct reproduction of the native posterior tibial slope (PTS) is essential for proper posterior cruciate ligament (PCL) tensioning, minimising wear of the polyethylene insert while ensuring stability on dense subchondral bone. This study assessed the accuracy of manually setting the tibial slope in KA TKA, comparing the conventional technique with the novel 'over-the-top' technique, hypothesising that the latter would provide greater accuracy and reproducibility, even for less experienced surgeons.

Femoral cartilage variability affects the accuracy of kinematic alignment and imageless navigation in total knee arthroplasty: A prospective study from the FP-UCBM Knee Study Group.

Purpose: Kinematic alignment (KA) and imageless computer-assisted surgery in total knee arthroplasty (TKA) typically compensate for cartilage wear by applying a standard 2-mm adjustment. However, recent concerns have emerged regarding the accuracy of this assumption. This study aimed to assess, for the first time in vivo, the femoral cartilage thickness on the unworn side in a consecutive series of TKA patients.

Coronal plane alignment of the knee phenotypes distribution varies significantly as a function of geographic, osteoarthritic and sex-related factors: A systematic review and meta-analysis.

Purpose: The coronal plane alignment of the knee (CPAK) classification is a nine-phenotype matrix based on limb alignment and joint line obliquity. This study aimed to provide a global overview of CPAK distribution, hypothesising significant geographic, osteoarthritic and sex-related variations.

Methods: A systematic literature search (Embase, Medline/PubMed and Cochrane Library) following PRISMA guidelines was conducted, utilising the search terms "Coronal Plane Alignment of the Knee" OR "CPAK".

Cementless unicompartmental knee arthroplasty is safe and effective at a minimum follow-up of 4.2 years: A systematic review.

Purpose: Cemented unicompartmental knee arthroplasty (UKA) is a widely used procedure in the treatment of anteromedial and lateral knee osteoarthritis. However, several advantages are reported for cementless UKA, such as improved osseointegration, reduced cement-related costs and complications. The aim of this study was to analyse clinical outcomes, survival, complications, failures and revision rate of cementless UKA.

Stress shielding influences shoulder function after reverse shoulder arthroplasty using a short stem at minimum 2 years follow-up and can be predicted using a preoperative planning software: A retrospective cohort study.

Background: The aim of the study was to assess if 3D CT-scan-based planification of distal filling ratio (DFR) is accurate when compared to postoperative DFR calculated on plain X-rays. A secondary aim was to investigate if an association between clinical outcomes and the degree of stress shielding (SS) exists.

Methods: Fifty patients with short-stem reverse shoulder arthroplasties, preoperative CT scans, and a minimum 24-month radiographic follow-up were included in the study.

Cartilage thickness can be accurately measured intraoperatively in total knee arthroplasty: A step further in calipered kinematic alignment.

Introduction: Kinematic alignment (KA) in total knee arthroplasty (TKA) is by definition a pure femoral resurfacing procedure aiming to restore the individual prearthritic anatomy. However, when a 2 mm compensation is systematically used on the worn side, the variability in cartilage thickness in the unworn compartment might alter the accuracy of the technique. This study aimed to validate two intraoperative femoral cartilage thickness measurement techniques by comparing them to the photographic method, which measures cartilage thickness through pixel analysis of bone-cut images.

Eccentricity and greater size of the glenosphere increase impingement-free range of motion in glenoid lateralized reverse shoulder arthroplasty: A computational study.

Introduction: Increasing the impingement-free Range Of Movement (ROM) is crucial for improving patient's functional outcome and reducing the rate of scapular notching. The purpose of this study was to compare, in a virtual model of Reverse Shoulder Arthroplasty with glenoid lateralization (L-RSA): 1) the impingement-free range of movement (ROM) between 155° Grammont-style inlay stem and 135° flushlay stem; 2) the effect of glenosphere size and type (centered vs eccentric) on impingement-free range of movement (ROM) using a 135° Neck Shaft Angle (NSA) flushlay stem.

Materials And Methods: 200 CT-scans of patients undergoing shoulder replacement for Cuff tear Arthropathy were analyzed in the present study.

Femoral cartilage thickness measured on MRI varies among individuals: Time to deepen one of the principles of kinematic alignment in total knee arthroplasty. A systematic review.

Purpose: Kinematically aligned total knee arthroplasty (KA TKA), as a pure resurfacing procedure, is based on matching implant thickness with bone cut and kerf thickness, plus cartilage wear. However, the assumption of a consistent 2 mm femoral cartilage thickness remains unproven. This study aimed to systematically review the available literature concerning magnetic resonance imaging (MRI) assessment of femoral cartilage thickness in non-arthritic patients.

Mechanically aligned total knee arthroplasty does not yield uniform outcomes across all coronal plane alignment of the knee (CPAK) phenotypes.

Purpose: Patient dissatisfaction rates following total knee arthroplasty (TKA) reported in the literature reach 20%. The optimal coronal alignment is still under debate. The aim of this retrospective study was to compare clinical outcomes in different coronal plane alignment of the knee (CPAK) phenotypes undergoing mechanically aligned (MA) TKA.

Femorotibial angle on short knee radiographs fails to accurately predict the lower limb mechanical alignment. A systematic review and meta-analysis on different femorotibial angle definitions and short knee radiograph types.

Introduction: Hip-knee-ankle angle (HKA) on Full Limb Radiographs (FLRs) is the gold standard for coronal knee alignment assessment. Despite the widespread utilization of the more convenient femorotibial angle (FTA) on either antero-posterior (AP) or postero-anterior (PA) short knee radiographs (SKRs), its definition and correlation with HKA remains controversial. This review is the first to systematically investigate FTA-HKA correlation and the effect of different FTA methods and SKRs.

No differences in terms of complications, readmissions, reoperations, and patient-reported outcomes in simultaneous bilateral versus staged bilateral total knee arthroplasty in selected patients.

Background: The safety and the clinical success of simultaneous bilateral total knee arthroplasty (BTKA) is controversial. The aim of this study was to compare complications and patient-reported outcomes following simultaneous BTKA (simBTKA) versus staged BKTA (staBTKA) in patients affected by bilateral symptomatic end-stage knee osteoarthritis (OA).

Methods: Data from patients who underwent simBTKA or staBTKA at a single institution from January 2017 to December 2020, with a minimum 1-year follow up period were retrospectively collected.

Comparison of knee flexor strength recovery between semitendinosus alone versus semitendinosus with gracilis autograft for ACL reconstruction: a systematic review and meta-analysis.

Background: Whether there is a difference in harvesting the semitendinosus tendon alone (S) or in combination with the gracilis tendon (SG) for the recovery of knee flexor strength after anterior cruciate ligament (ACL) reconstruction remains inconclusive. Therefore, this study aimed to assess the recovery of knee flexor strength based on the autograft composition, S or SG autograft at 6, 12, and ≥ 24 months after ACL reconstruction.

Methods: A systematic review and meta-analysis was conducted following the PRISMA guidelines.

Machine learning can predict anterior elevation after reverse total shoulder arthroplasty: A new tool for daily outpatient clinic?

The aim of the present study was to individuate and compare specific machine learning algorithms that could predict postoperative anterior elevation score after reverse shoulder arthroplasty surgery at different time points. Data from 105 patients who underwent reverse shoulder arthroplasty at the same institute have been collected with the purpose of generating algorithms which could predict the target. Twenty-eight features were extracted and applied to two different machine learning techniques: Linear regression and support vector regression (SVR).

Influence of Lateralization and Distalization on Joint Function after Primary Reverse Total Shoulder Arthroplasty.

The purpose of this study was to investigate how lateralization shoulder angle (LSA) and distalization shoulder angle (DSA) are related to clinical and kinematic outcomes after reverse total shoulder arthroplasty. Thirty-three patients were evaluated at least six months postoperatively. The Single Assessment Numeric Evaluation (SANE), Constant Murley Score (CMS), Simple Shoulder Test (SST), and Visual Analogue Scale (VAS) were used.

Angled BIO-RSA leads to better inclination and clinical outcomes compared to Standard BIO-RSA and eccentric reaming: A comparative study.

Background: Two surgical techniques were compared : Standard BIO-RSA, performed with a glenoid eccentric reaming along with a cylindric bone graft augmentation vs. the Angled BIO-RSA, performed with a glenoid concentric reaming and a defect correction with an angled bone graft.

Methods: Patients undergoing RSA from January 2016 to April 2019, with one of the two techniques being performed, were retrospectively reviewed.

Restricted kinematic alignment is clinically non-inferior to mechanical alignment in the short and mid-term: A systematic review.

Background: In recent years, kinematic alignment (KA) is becoming a valid alternative to mechanical alignment (MA) in total knee arthroplasty (TKA). However, to avoid early failures, the restricted kinematic alignment (rKA) approach has been developed to restore native knee kinematics without reproducing extreme knee phenotype. This systematic review aims to evaluate clinical and radiological outcomes between rKA and MA for TKA.

Allograft Prosthesis Composite (APC) for Proximal Humeral Bone Loss: Outcomes and Perspectives.

(1) Background: Allograft prosthetic composite (APC) represents one of the techniques used for reconstruction in large proximal humeral bone deficits. The present systematic review aimed at summarizing the state of the art of the technique and analyzing its outcomes. (2) Methods: The PRISMA guidelines were followed to perform this systematic review.

Isolated Large Glenoid Fracture and Acute Glenohumeral Dislocation in Elderly Patients: A Case Series Treated Surgically With Reverse Shoulder Arthroplasty and Augmented Glenoid.

Background: One of the most frequent complications in patients affected by traumatic anterior dislocations is bony Bankart lesion. This study evaluates the clinical and functional outcomes of 10 patients with isolated large glenoid fracture and acute glenohumeral dislocation treated with reverse shoulder arthroplasty.

Methods: Patients older than 69 years who underwent reverse shoulder arthroplasty after isolated large glenoid fracture and acute glenohumeral dislocation between 2016 and 2022 at the same institute were selected.

MicroRNA expression changes in the development of rotator cuff tendon injuries.

Traumatic or degenerative rotator cuff (RC) tendon injuries are a leading cause of persistent shoulder pain and reduction of mobility with associated disability and dysfunction, which require each year more than 250,000 surgical repairs in the United States. MicroRNAs (miRNAs) are small noncoding RNAs, that in the posttranscriptional phase lead to the development and function of tissues. The aim of this review was to identify miRNA expression changes in patients with RC pathologies and to determine their relevance as a potential novel diagnostic and potentially therapeutic tool for RC disorders.

Aspirin is a safe and effective thromboembolic prophylaxis after total knee arthroplasty: a systematic review and meta-analysis.

Purpose: Patients undergoing total knee arthroplasty (TKA) are at high risk for thromboembolic events compared to non-surgical patients. Both anticoagulants and antiplatelet agents are used as antithrombotic prophylaxis in TKA. The aim of this review is to understand the role of aspirin in the prevention of thromboembolic events and to compare its efficacy and safety with the main anticoagulants used in antithromboembolic prophylaxis in TKA.

Unicompartmental knee arthroplasty (UKA) for primary spontaneous osteonecrosis of the knee (SONK): a systematic review.

Introduction: The role of unicompartmental knee arthroplasty (UKA) in spontaneous osteonecrosis of the knee (SONK) is still controversial.

Materials And Methods: We performed a systematic review to evaluate all available current literature on UKA in the setting of SONK. A comprehensive electronic research was performed using the PubMed, Embase, Web of Science, and Cochrane databases with keywords related to SONK and knee arthroplasty.