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Purpose: To evaluate the relationship between pre‐ and postoperative joint line convergence angle (JLCA) changes and patient‐reported outcome measures related to medial open‐wedge high tibial osteotomy (MOWHTO). Methods: Sixty‐one patients (71 knees) who underwent MOWHTO were examined. Preoperative and 2‐year postoperative radiographic parameters (hip–knee–ankle angle, weight‐bearing line ratio, medial proximal tibial angle and JLCA) were measured, and knee injury and osteoarthritis outcome scores (KOOS) were assessed. Patients were divided into two groups: group D (decreased JLCA compared with preoperative status) included 44 knees with a ΔJLCA < 0° and group I (increased JLCA and no‐change JLCA compared with preoperative status) included 27 knees with a ΔJLCA ≥ 0°. KOOS sub‐scores and the proportion of patients whose improvement exceeded the minimum clinically important difference (MCID) were compared between both groups using Student's t tests, Mann–Whitney U tests and chi‐square tests. Multiple regression analysis was performed to determine the factor that had an influential effect on the postoperative KOOS total. Results: Significant differences in 2‐year postoperative KOOS were observed between the two groups, including total, symptom, pain and activities of daily living scores. Group D had significantly more patients who achieved MCID for both KOOS symptoms and pain scores than group I did. Multivariate analysis indicated that JLCA change and body mass index were significantly associated with the postoperative KOOS total. Conclusion: Patients with decreased JLCA had better 2‐year post‐MOWHTO KOOS and better symptom and pain improvements. Therefore, strategies that reduce JLCA are crucial to improving clinical outcomes, and efforts should be made to improve JLCA in surgical techniques. Level of Evidence: Level Ⅳ, Case series. [ABSTRACT FROM AUTHOR]

The menisci have a poor intrinsic healing capability. Biological augmentation is used to promote meniscal healing in conjunction with suture techniques as the result of their poor healing rate. A fibrin clot (FC) is a well-known treatment option for meniscal injuries that are difficult to heal. Several methods for delivering FCs to target sites have been reported; however, all available methods have drawbacks such as unstable delivery, low maneuverability, and/or clot sizes that are too large. We use a dedicated device to efficiently deliver FCs of a suitable size for the tear. In this method, an FC formed to a size of 5 mm is stored and delivered in a thin syringe with a built-in plunger. This method enables an accurate delivery of a suitably sized FC to the desired location and fixes FCs to the tear site when used in combination with conventional suture methods. In this report, we will succinctly describe how to make and deliver an FC using the aforementioned device with a step-by-step instructional technique and an illustrative video. [Display omitted] [ABSTRACT FROM AUTHOR]

Objective: The use of 2-octyl cyanoacrylate with polyester mesh (OCA-M) has become common in total hip and knee arthroplasty (THA, TKA). We aimed to compare the safety and cosmetic outcomes between OCA-M and standard suture techniques and staples, and determine whether OCA-M can safely be used for TKA. Method: Inclusion criteria were patients who underwent THA or TKA from January 2010 to October 2011 (Suture group), November 2011 to August 2013 (Staple group), March 2017 to September 2018 (OCA-M group). Exclusion criteria was loss of imaging data. Complications during hospitalisation (early complication) and after discharge (late complication) were compared in groups. Plastic and orthopaedic surgeons performed cosmetic evaluations with the modified Vancouver Scar Scale (VSS) and Likert scale at three and six months postoperatively and compared in groups. Results: A total of 249 arthroplasties (suture group=88 patients; staple group=94 patients; OCA-M group=67 patients) were included in the study. The OCA-M group had a significantly lower early complication rate than the suture group (p=0.015). For THA, the OCA-M group had a significantly lower total complication rate than the suture group (p=0.048). For TKA, there was no significant difference among the three groups. The complication rate in the OCA-M group showed no significant difference between THA/TKA. With regards to the VSS, the OCA-M group was significantly better for cosmetic qualities than the suture group (p=<0.001, p=0.021 at three and six months, respectively). For the Likert scale, the OCA-M group was also significantly better for cosmetic qualities than the suture group and staple group (suture–OCA-M, p=0.003 (three months), p=<0.001 (six months); staple–OCA-M, p=0.027 (three months)). Conclusion: In this study, the OCA-M complication rate was low compared to suturing and similar to stapling. Moreover, better cosmetic outcomes were achieved compared to suturing and stapling. [ABSTRACT FROM AUTHOR]