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We compared the intraoperative varus-valgus stability from 0° to 90° of flexion and postoperative clinical outcomes in patients receiving TKA via either a single-radius femoral design (50 TKA, SR group) or multi-radius femoral design (50 TKA, MR group). We measured stabilities at 0°, 30°, 60° and 90° of flexion using a navigation system. The clinical outcomes including HSS scores, WOMAC scores and VAS score during stair climbing were compared after a minimum of 2-year follow-up. The single-radius femoral designs in TKA showed better intra-operative stability at 30° of flexion (7.6 vs. 8.3) compared with the multi-radius femoral design, but not at other angles. However, the clinical outcomes revealed no other significant differences in terms of HSS scores, WOMAC scores and VAS score between two groups. [ABSTRACT FROM AUTHOR]

Abstract: The purpose of this study was to compare clinical outcomes including return to recreational activities (cycling, swimming, exercise walking, dancing, jogging, and mountain climbing) after opening-wedge high tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA). Clinical outcomes were assessed using Tegner activity scores, ranges of motion, and Lysholm knee scores. In both groups, the number of patients participating in recreational activities was significantly reduced after surgery, but without a significant intergroup difference (1.3 activities in HTO group and in 1.6 activities in UKA group). Average Tegner activity scale scores, ranges of motion, and Lysholm knee scores did not show significant differences between the 2 groups. This study identified no significant differences between HTO and UKA for medial unicompartmental osteoarthritis in terms of return to recreational activity and short-term clinical outcomes. [Copyright &y& Elsevier]

Purpose: The purpose of this study was to compare the clinical and radiographic outcomes of opening- and closing-wedge valgus high tibial osteotomy (HTO) for the treatment of medial unicompartmental knee osteoarthritis with a minimum follow-up of 3 years, with a focus on patellofemoral alignment and anterior knee pain. Methods: We performed a retrospective comparison of 50 patients who underwent closing-wedge HTO and 50 patients who underwent opening-wedge HTO for isolated medial joint arthritis of the knee with varus deformity. All patients were evaluated and the 2 study groups were compared after a minimum follow-up of 3 years with a focus on patellofemoral alignment, patellofemoral osteoarthritis, and anterior knee pain while climbing stairs. Results: Patellar alignment (patellar tilt and lateral patellar displacement) was not significantly different in the 2 groups either preoperatively or at follow-up. Furthermore, there were no significant differences in the extent of patellofemoral arthritis and incidence of anterior knee pain at follow-up between the 2 groups. In addition, no significant intergroup difference was found in terms of the incidence of anterior knee pain (28% in closing-wedge group and 32% in opening-wedge group at follow-up). Conclusions: The results of closing- and opening-wedge valgus HTO were not found to be significantly different with respect to patellar alignment, osteoarthritis of the patellofemoral joint, or anterior knee pain. Level of Evidence: Level III, retrospective comparative study. [ABSTRACT FROM AUTHOR]

Abstract: The effects of different femoral component designs on intraoperative range of motion were examined in 40 female patients during primary cruciate-retaining (CR) total knee arthroplasty. After complete bone resection and soft tissue balancing, standard CR, high-flexion, and gender-specific knee trials were sequentially inserted, and maximal flexion and extension under gravity were measured using a navigation system. Average maximal flexions were 134.3° for standard CR knees, 136.2° for high-flexion knees, and 136.4° for gender-specific knees. No significant intergroup differences in intraoperative maximal flexion and extension were found (P > .05). High-flexion and gender-specific femoral designs were found to show subtle increases in intraoperative range of motion as compared with the standard design but no significant differences. [Copyright &y& Elsevier]

Abstract: The clinical and radiologic results of a gender-specific total knee arthroplasty design were compared with those of a conventional unisex design in 50 female patients with bilateral osteoarthritis and a minimum follow-up of 2 years. Total knee arthroplasty was performed using a conventional unisex implant in one knee and a gender-specific implant in the other. Clinical outcomes, which included range of motion, Hospital for Special Surgery scores, and Western Ontario and McMaster Universities Osteoarthritis Index scores, were compared. In addition, patients'' subjectively preferred sides were noted, and radiologic results based on implant positions, posterior offsets, anterior offsets, and patellofemoral alignments were evaluated. No significant differences were observed between range of motion, Hospital for Special Surgery score, or Western Ontario and McMaster Universities Osteoarthritis Index scores. Patient subjective preferences and radiologic results were also similar for both sides. In conclusion, gender-specific knees in female total knee patients showed no advantages over standard unisex knees in terms of clinical or radiologic outcomes. [Copyright &y& Elsevier]

Abstract: The purpose of this study was to evaluate the results of liner cementation into a stable acetabular shell using a metal-inlay polyethylene liner in 39 revision total hip arthroplasties. After an average of 2.8 years, 1 cemented liner dislodged from its metal shell at a postoperative 4 years. In the other 38 hips, mean Harris hip scores improved from 65 preoperatively to 86.9 at the final follow-up. Eighteen patients were rated as having excellent results, 17 as good, and 3 as fair. There were no changes in cup position and no cases of osteolytic lesion progression around the femoral and acetabular components in the last follow-up radiographs. Metal-inlay polyethylene liner cementation into a stable acetabular shell was found to provide an alternative option with short-term excellent results, and it also offers more liner options, the preservation of bone stock, and lower surgical morbidity. [Copyright &y& Elsevier]

BACKGROUND CONTEXT Although there were many studies about the application of the TLICS classification to thoracolumbar spine injuries, large-scale studies of efficacy in treated patients were rarely investigated. PURPOSE This study aimed to assess the efficacy of TLICS classification in the selection of treatment methods for patients with thoracolumbar spine injury. METHODS From 2000 to 2016, we retrospectively studied 330 patients who were treated for thoracolumbar spine injuries. Clinical results and radiological data were studied and analyzed using ASIA scale, Magerl/AO classification and TLICS classification. RESULTS Among 330 patients, 139 patients (42.1%) received conservative treatment and 191 patients (57.9%) received surgical treatment. Of the 139 patients who underwent conservative treatment, 128 patients (92.1%) were consistent with the recommended treatment in TLICS. Of the patients who underwent conservative treatment, 10 patients (7.2%) failed conservative treatment and required surgical treatment. On the other hand, out of a total of 191 patients who underwent surgical treatment, 160 patients (83.8%) were consistent with the recommended treatment in TLICS. CONCLUSIONS The TLICS classification is highly effective in the conservative treatment of thoracolumbar junction injury. In addition, it has relatively good efficacy in surgical treatment [ABSTRACT FROM AUTHOR]

Various methods such as laminectomy, laminoplasty, and/or laminotomy can be used to remove intraspinal lesions. However, laminoplasty has generally been known to be able to prevent postoperative instability and deformity and avoid local scarring at operative site. We have described a new laminoplasty technique that can preserve the interspinous ligament during thoracolumbar intraspinal surgery. Ten patients undergoing laminoplastic tumor excision were evaluated preoperatively and postoperatively with neurologic examinations, a pain visual analog scale, and the Oswestry Disability Index. Instability and fusion were evaluated with plain radiography and computed tomography. The operative time, complications, and hospital stay were also assessed. We assessed the data from 10 patients (12 disc levels) with intradural extramedullary tumor who had undergone a ligament-saving laminoplasty procedure. Of the 10 tumors, 6 were schwannoma, 2 were meningioma, 1 was extra-adrenal paraganglioma, and 1 was metastatic adenocarcinoma. Spinal computed tomography was performed 6 months postoperatively. Complete union of the laminoplasty site was achieved for all 10 patients. The flexion-extension view of the plain radiograph was compared with the preoperative images to evaluate the stability of the operated level. No patient had range of motion limitation or instability. Ligament-saving laminoplasty can provide an appropriate surgical view and allow for anatomical reconstruction of the spinal posterior element after excision of spinal cord tumors. This procedure might offer an alternative to classic techniques for selected patients to preserve spinal biomechanical function. [ABSTRACT FROM AUTHOR]

Background Context: Many complications of lumbar fusion have been reported. However, reports of complications related to implant removal after solid fusion are rare. In addition, there are almost no reports of compression fractures occurring within a fusion mass. Purpose: This work aimed to report a case of vertebral body compression fracture within a solid lumbar fusion mass after removal of fusion instrumentation, and to investigate the contributing factors. Study Design: A case report was carried out. Methods: A 67-year-old woman presented with gait disturbance and pain radiating from both lower extremities. She had a history of lumbar fusion at L2-L5 because of degenerative stenosis. We found spinal stenosis at L5-S1 and ossification of the ligamentum flavum at T12-L2. Posterior decompression and fusion were performed for the lesion, and previously inserted fusion instrumentation was removed at L2-L5 in accordance with the patient's request. After surgery, her symptoms decreased and she was discharged. Five weeks after surgery, the patient returned with sudden, severe back pain that occurred without trauma. Compression fracture at the L3 lower end plate was observed via magnetic resonance imaging. We treated her back pain with analgesics and a thoracolumbosacral orthosis. After 2 weeks, her back pain had decreased, and she was discharged. Results: Before removal of instrumentation, we verified complete union using computed tomography. However, an unexpected compression fracture occurred within the fusion mass, without trauma. We suspect that the causes of the compression fracture were the straight sagittal imbalance of the spine, the cantilever motion in the anterior disc after posterior fusion, and decreased bone strength. Conclusions: Vertebral compression fracture in a solid fusion mass may occur as a complication of implant removal. Surgeons must take care to maintain normal sagittal alignment during spinal fusion, and they should consider careful removal of instrumentation for patients with risk factors such as osteoporosis, sagittal imbalance, long spine fusion, and certain types of fusion. [ABSTRACT FROM AUTHOR]