Displaying all 3 publications

  1. Lovisetti G, Vulcano E, Bettella L, Tasarib R, Tondolo T, Sala F
    J Knee Surg, 2018 May;31(5):459-466.
    PMID: 28719943 DOI: 10.1055/s-0037-1604139
    Surgical reconstruction of bicondylar tibial fractures with external fixation relies on indirect fracture reduction that could affect anatomical restoration. The aim of the present study is to evaluate the radiographic and clinical outcomes of tibial bicondylar fractures treated with circular external fixation. A total of 20 bicondylar fractures of the proximal tibia in 20 patients treated with circular external fixation were included in the study. Two fractures were open. Mean clinical and radiographic follow-up was 37.3 months after frame removal. Angular, translation, and length deformities were assessed on nonweight-bearing anteroposterior, lateral, and two 45 degrees oblique views. The medial proximal tibia (MPTA) and posterior proximal tibia angles (PPTA) were calculated in all cases. The condylar widening was calculated in relation to the width of the femoral condyles. Joint depressions or gaps of the articular surface were identified on the four views of the knee. The modified Hospital for Special Surgery (HSS) knee scoring system was used for clinical evaluation. The MPTA was good in 18 (90%) and fair in 2 patients (10%). The PPTA was good in 13 (65%), fair in 6 (30%), and poor in 1 patient (5%). The articular reduction was good in 12 (60%) and fair in 8 patients (40%). The condylar widening was good in 15 (75%) and fair in 5 patients (25%). Mechanical axis deviation was within the normal range in 11/12 patients (91.7%). All fractures consolidated. One deep infection was successfully treated with local debridement, the mean modified HSS knee score at the latest follow-up was 90.5 (range: 67-100). Articular reconstruction and tibia alignment based on radiographic evaluation in the present study, along with functional results compare favorably with those of external and internal fixation presented in the literature.
  2. Lee M, Ho JPY, Chen JY, Ng CK, Yeo SJ, Merican AM
    J Knee Surg, 2022 Feb;35(3):280-287.
    PMID: 32629512 DOI: 10.1055/s-0040-1713733
    BACKGROUND:  Restoration of the anatomical joint line, while important for clinical outcomes, is difficult to achieve in revision total knee arthroplasty (rTKA) due to distal femoral bone loss. The objective of this study was to determine a reliable method of restoring the anatomical joint line and posterior condylar offset in the setting of rTKA based on three-dimensional (3D) reconstruction of computed tomography (CT) images of the distal femur.

    METHODS:  CT scans of 50 lower limbs were analyzed. Key anatomical landmarks such as the medial epicondyle (ME), lateral epicondyle, and transepicondylar width (TEW) were determined on 3D models constructed from the CT images. Best-fit planes placed on the most distal and posterior loci of points on the femoral condyles were used to define the distal and posterior joint lines, respectively. Statistical analysis was performed to determine the relationships between the anatomical landmarks and the distal and posterior joint lines.

    RESULTS:  There was a strong correlation between the distance from the ME to the distal joint line of the medial condyle (MEDC) and the distance from the ME to the posterior joint line of the medial condyle (MEPC) (p 

  3. Lee JI, Jaffar MSA, Choi HG, Kim TW, Lee YS
    J Knee Surg, 2022 Feb;35(3):299-307.
    PMID: 32659817 DOI: 10.1055/s-0040-1713898
    The purpose of this study was to evaluate the outcomes of isolated medial patellofemoral ligament (MPFL) reconstruction, regardless of the presence of predisposing factors. A total of 21 knees that underwent isolated MPFL reconstruction from March 2014 to August 2017 were included in this retrospective series. Radiographs of the series of the knee at flexion angles of 20, 40, and 60 degrees were acquired. The patellar position was evaluated using the patellar tilt angle, sulcus angle, congruence angle (CA), and Caton-Deschamps and Blackburne-Peel ratios. To evaluate the clinical outcome, the preoperative and postoperative International Knee Documentation Committee (IKDC) and Lysholm knee scoring scales were analyzed. To evaluate the postoperative outcomes based on the predisposing factors, the results were separately analyzed for each group. Regarding radiologic outcomes, 20-degree CA was significantly reduced from 10.37 ± 5.96° preoperatively to -0.94 ± 4.11° postoperatively (p = 0.001). In addition, regardless of the predisposing factors, delta values of pre- and postoperation of 20-degree CA were not significantly different in both groups. The IKDC score improved from 53.71 (range: 18-74) preoperatively to 94.71 (range: 86-100) at the last follow-up (p = 0.004), and the Lysholm score improved from 54.28 (range: 10-81) preoperatively to 94.14 (range: 86-100) at the last follow-up (p = 0.010). Isolated MPFL reconstruction provides a safe and effective treatment for patellofemoral instability, even in the presence of mild predisposing factors, such as trochlear dysplasia, increased patella height, increased TT-TG distance, or valgus alignment. This is a Level 4, case series study.
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