Purpose/Hypothesis: The purpose of this study was to compare the clinical and radiologic outcomes of remnant-preserving PCL reconstruction using anatomic versus low tibial tunnels. We hypothesized that the outcomes of low tibial tunnel placement would be superior to those of anatomic tibial tunnel placement at the 2-year follow-up after remnant-preserving PCL reconstruction.
Study Design: Cohort study; Level of evidence, 3.
Methods: We retrospectively reviewed the data for patients who underwent remnant-preserving PCL reconstruction between March 2011 and January 2018 with a minimum follow-up of 2 years (N = 63). On the basis of the tibial tunnel position on postoperative computed tomography, the patients were divided into those with anatomic placement (group A; n = 31) and those with low tunnel placement (group L; n = 32). Clinical scores (International Knee Documentation Committee subjective score, Lysholm score, and Tegner activity level), range of motion, complications, and stability test outcomes at follow-up were compared between the 2 groups. Graft signal on 1-year follow-up magnetic resonance imaging scans was compared between 22 patients in group A and 17 patients in group L.
Results: There were no significant differences between groups regarding clinical scores or incidence of complications, no between-group differences in posterior drawer test results, and no side-to-side difference on Telos stress radiographs (5.2 ± 2.9 mm in group A vs 5.1 ± 2.8 mm in group L; P = .900). Postoperative 1-year follow-up magnetic resonance imaging scans showed excellent graft healing in both groups, with no significant difference between them.
Conclusion: The clinical and radiologic outcomes and complication rate were comparable between anatomic tunnel placement and low tibial tunnel placement at 2-year follow-up after remnant-preserving PCL reconstruction. The findings of this study suggest that both tibial tunnel positions are clinically feasible for remnant-preserving PCL reconstruction.
Purpose: To analyze the injury rates, patterns, and risk factors of functional training/CrossFit.
Study Design: Descriptive epidemiology study.
Methods: Electronic questionnaires were distributed to 244 participants from 15 centers in the country. Descriptive data regarding the athletes, injury occurrence within the past 6 months, injury details, and risk factors were collected.
Results: Of the 244 athletes, 112 (46%) developed at least 1 new injury over the previous 6 months. Injury rates were significantly higher in athletes from nonaffiliate training gyms compared with CrossFit-affiliated gyms, in athletes with previous injuries, and in those who perceived themselves as having more than average fitness.
Conclusion: Coaches and athletes need to be more aware of risk factors for injury to enable safer and better training strategies.
PURPOSE: To compare the clinical outcomes after UKA and HTO in patients with SONK.
STUDY DESIGN: Cohort study; Level of evidence, 3.
METHODS: This retrospective study included 42 patients who had undergone Oxford UKA and 40 patients who had undergone opening-wedge HTO between 2014 and 2020. All patients were diagnosed with isolated medial SONK without subchondral collapse of the femoral condyle and tibial plateau. The patients were preoperatively and postoperatively evaluated using the Lysholm knee scoring system, the Western Ontario and McMaster Universities Osteoarthritis Index, and a numeric rating scale assessing patient satisfaction.
RESULTS: Patients in the UKA group were significantly older than those in the HTO group (median age, 71.5 years [IQR, 68.0-76.5 years] vs 65.0 years [IQR, 60.0-70.0 years], respectively; P < .001). The median follow-up time was 3.78 years (IQR, 2.45-4.53 years) for the UKA group and 3.87 years (IQR, 2.90-5.60 years) for the HTO group. Significant improvements in functional scores were observed in both the UKA and HTO groups (P < .001 for all), with no significant between-group differences in scores at the final follow-up (≥2 years after surgery). The satisfaction rate was similar (80.95% for UKA and 75.0% for HTO).
CONCLUSION: According to the study results, significant improvements in clinical outcomes were seen after opening-wedge HTO with microfracture for a younger group of patients with SONK without subchondral collapse, while Oxford UKA had a comparable effect on an older group of patients. Both UKA and HTO were found to be viable surgical approaches for SONK at short- to midterm follow-up.