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BackgroundThe prevalence of knee osteoarthritis in Southeast Asia has increased steadily over the years. When conservative management options fail, total knee arthroplasty (TKA) is a reliable surgical option. Despite over 90% post-operative satisfaction, the high volume of TKAs performed means that even a small percentage of dissatisfied patients holds significance. Dissatisfaction often arises from unmet expectations, which are influenced by cultural and urban factors specific to the region. Surgeons must counsel patients on likely post-operative activities, but limited data on knee range of motion (ROM) for daily tasks in Southeast Asia renders personalised guidance challenging.AimThe primary aim of this study was to evaluate the minimum knee ROM required for daily activities (walking, stair climbing, squatting, kneeling, and sitting cross-legged) in a healthy Southeast Asian urban population. The secondary aim was to determine the association between anthropometric measurements and knee ROM required for the activities. This information is useful in managing patient expectations after TKA.MethodsAn email describing the study was sent to hospital staff to recruit them as volunteers for the study. Enrolled participants were required to be between the ages of 21 and 65 years and capable of providing informed consent. Interested volunteers with a past medical history involving the lower limbs and spine were excluded. Those with a history of lower limb joint pain or back pain within the last 1 year were also excluded. The KINEXCS KIMIA device (KIMIA Recover System, 2022 edition v1.0) was used to measure the knee ROM. The overall characteristics of participants were summarised using descriptive statistics. Anthropometric measurements and their association with knee ROM during the various activities were analysed. Variables with p-values

Abstract Introduction The number of primary and revision Total Knee Arthroplasty (TKA) cases are expected to increase in future. There are various advantages and disadvantage to employing either of the two main types of stem fixation methods – cemented or hybrid technique. This review aimed to study the most optimal fixation method for revision TKAs by comparing radiological outcomes and re-revision rates. Methods A systematic review and meta-analysis was performed using PubMed and Cochrane Library from 2010 to identify studies explicitly comparing outcomes between cemented against hybrid fixation revision TKA techniques, with a minimum follow up of at least 24 months. A total of 8 studies was included in this review. Egger’s test and visual inspection of the funnel plot did not reveal publication bias. Results There was no statistically significant difference in radiological failure and loosening (OR 0.79, CI 0.37–1.66, I2 = 29%, p = 0.22), all causes of re-revision (OR 1.03, CI 0.73–1.44, I2 = 0%, p = 0.56) and aseptic revision (OR 0.74, CI 0.27–2.02, I2 = 0%, p = 0.41) between cemented and hybrid techniques. Functional and pain outcomes compared between the two fixation techniques were largely similar across the studies included in this meta-analysis. Conclusion Despite a trend favouring hybrid stems in revision TKA, current evidence revealed that radiological outcomes and re-revision rates are largely similar between cemented and hybrid fixation techniques.

Surgical reconstruction of the medial collateral ligament (MCL) can be challenging during multi-ligament knee injury surgery due to the limited working space. There is risk of collision between the guide pin, pulling sutures, reamer, tunnel, implant, and graft of the different ligament reconstructions. In this Technical Note, we detail our senior author’s technique for superficial MCL reconstruction using suture anchors and cruciate ligament reconstruction with all-inside techniques. The technique mitigates the risk of collision by confining the reconstruction process and implants for MCL fixation on the medial femoral condyle and medial proximal tibia.

Abstract Background This is an experimental study conducted to assess whether the fibular head is a reliable reference point to identify the position of the common peroneal nerve at the posterolateral corner of the knee. Materials and methods Twelve cadaveric knees were dissected through the lateral approach. The common peroneal nerve was identified and traced. The location where the common peroneal nerve crossed the posterior border of the biceps femoris and the posterior border of the fibular neck were designated as points B and N, respectively. The tip of the fibular head was designated F. Distances FB and FN were measured and the triangular area FBN was calculated at various degrees of knee flexion. Results During knee motion, distance FN showed minimal change and was not affected by variation in degrees of knee flexion (p = 0.131). Distance FB and distance BN were affected by variation in degrees of knee flexion (p