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Medicina
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Cutting-Edge Concepts in Knee Surgery
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Cutting-Edge Concepts in Knee Surgery

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: 30 November 2024 | Viewed by 5549

Special Issue Editor

Dr. Dhong Won Lee

E-Mail Website
Guest Editor
Department of Orthopaedic Surgery, Konkuk University Medical Center, Konkuk University, Seoul, Republic of Korea
Interests: ACL injury; sports injury; meniscal root tear; anterior cruciate ligament reconstruction; meniscal allograft transplantation; cartilage repair, high tibial osteotomy

Special Issue Information

Dear Colleagues,

Most knee surgeries aside from artificial joint surgery are now treated with arthroscopy, which has become a standard surgical procedure. Around the world, many orthopaedic surgeons passionately find innovative approaches and ways of carrying out trials to share and advance the field of knee surgery.

We believe that these efforts will lead to a delay in or prevention of joint arthroplasty and other concomitant diseases in this aging society.

The aim of this Special Issue of Medicina is to present new advances in knee arthroscopic surgeries for sports injuries and disorders. This Special Issue is open to studies for new surgical techniques, evolved diagnosis, clinical outcomes, rehabilitation strategies, and current reviews.

We invite authors to submit articles related to knee arthroscopy.

Dr. Dhong Won Lee
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • knee
  • anterior cruciate ligament
  • anterolateral ligament
  • posterior cruciate ligament
  • meniscus
  • cartilage
  • arthroscopy
  • sports medicine

Published Papers (5 papers)

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Research

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17 pages, 4797 KiB  
Article
The Association between the Extent of the Osteoarthritic Meniscus Degeneration and Cigarette Smoking—A Pilot Study
by Maria Zabrzyńska, Maciej Pasiński, Maciej Gagat, Michał Kułakowski, Łukasz Woźniak, Karol Elster, Paulina Antosik and Jan Zabrzyński
Medicina 2024, 60(2), 323; https://doi.org/10.3390/medicina60020323 - 14 Feb 2024
Viewed by 724
Abstract
Background and Objectives: The negative effects of smoking on the musculoskeletal system were presented by many authors, although the relationship between smoking and osteoarthritis remains unclear. The aim of this paper was to investigate the negative effects of smoking on meniscal tissue [...] Read more.
Background and Objectives: The negative effects of smoking on the musculoskeletal system were presented by many authors, although the relationship between smoking and osteoarthritis remains unclear. The aim of this paper was to investigate the negative effects of smoking on meniscal tissue in osteoarthritic knees by microscopic examination, by adapting the Bonar scoring system and its modifications. Materials and Methods: The study involved 34 patients with varus knees, from whom 65 samples of knee menisci were obtained. The mean age in the studied group was 65.385 years. The smoking status of the patients concluded that there were 13 smokers and 21 nonsmokers. Results: Among smokers, the mean classical Bonar score was 8.42 and the mean modified Bonar score was 6.65, while nonsmokers were characterized by scores of 8.51 and 7.35, respectively. There was a statistically significant negative correlation between the number of cigarettes and the collagen in the medial meniscus (p = 0.0197). Moreover, in the medial meniscus, the modified Bonar score correlated negatively with the number of cigarettes (p = 0.0180). Similarly, such a correlation was observed between the number of cigarettes and the modified Bonar score in the lateral meniscus (p = 0.04571). Furthermore, no correlation was identified between the number of cigarettes and the classical Bonar score in the lateral meniscus. There was a statistically significant difference in the collagen variable value between the smokers and nonsmokers groups (p = 0.04525). Conclusions: The microscopic investigation showed no differences in the menisci of smokers and nonsmokers, except for the collagen, which was more organized in smokers. Moreover, the modified Bonar score was correlated negatively with the number of cigarettes, which supports the role of neovascularization in meniscus pathology under the influence of tobacco smoking. Full article
(This article belongs to the Special Issue Cutting-Edge Concepts in Knee Surgery)
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12 pages, 3821 KiB  
Article
Sex Differences in Sarcopenia in Patients Undergoing Total Knee Arthroplasty for Advanced Knee Osteoarthritis
by Oog-Jin Shon, Gi Beom Kim and Seong Hyeon Jo
Medicina 2024, 60(2), 226; https://doi.org/10.3390/medicina60020226 - 28 Jan 2024
Viewed by 701
Abstract
Background and Objectives: The purpose of this study was to compare sex differences in the incidence of sarcopenia, demographic characteristics, and preoperative sarcopenic parameters in patients undergoing TKA for advanced knee osteoarthritis (OA). Moreover, we sought to compare patient-reported outcome measures (PROMs) and [...] Read more.
Background and Objectives: The purpose of this study was to compare sex differences in the incidence of sarcopenia, demographic characteristics, and preoperative sarcopenic parameters in patients undergoing TKA for advanced knee osteoarthritis (OA). Moreover, we sought to compare patient-reported outcome measures (PROMs) and the predisposing factors after TKA in patients with sarcopenia by sex through subgroup analysis. Materials and Methods: From May 2020 to September 2022, a total of 892 patients who were evaluable for sarcopenia before primary TKA were enrolled. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 criteria. Patients were assessed according to the presence or absence of sarcopenia. After a two-to-one matched-pair analysis for subgroup analysis, 21 knees in men were matched with a corresponding number of knees in women (42), resulting in a total of 63 knees. PROMs were investigated using the Knee Injury and Osteoarthritis Outcome Score, Western Ontario and McMaster Universities Osteoarthritis Index, and the Short Form-12 physical and mental component summary scores. Moreover, the postoperative complications and predisposing factors for male sarcopenia were investigated. Results: The prevalence of sarcopenia was 10.9% (97/892), and the prevalence was higher in men (19.6%, 21/107) than in women (9.7%, 76/785). In subgroup analyses, male patients had significantly inferior PROMs up to 12 months after index surgery. Moreover, there was no significant difference in the systemic complications between the two groups. Multivariate binary logistic regression analysis indicated that alcohol consumption, smoking, and higher modified Charlson Comorbidity Index (mCCI) were predisposing factors for male patients with sarcopenia. The prevalence of sarcopenia was higher in male patients undergoing primary TKA. Conclusions: When compared with the propensity-matched female group, male patients had inferior PROMs up to 12 months postoperatively. Alcohol consumption, current smoker status, and higher mCCI were predisposing factors for sarcopenia in male patients with advanced knee OA. Full article
(This article belongs to the Special Issue Cutting-Edge Concepts in Knee Surgery)
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12 pages, 5782 KiB  
Article
Femoral Tunnel Geometry and Graft Inclination Angles in Anterior Cruciate Ligament Reconstruction Using a Flexible Reamer System
by Dhong-Won Lee, Dong-Hwan Lee, Sung-Gyu Moon, Ji-Hee Kang, Young-Je Woo and Woo-Jong Kim
Medicina 2023, 59(6), 1031; https://doi.org/10.3390/medicina59061031 - 26 May 2023
Cited by 2 | Viewed by 1236
Abstract
Background and Objectives: The aim of this study is to investigate the femoral tunnel geometry (femoral tunsnel location, femoral graft bending angle, and femoral tunnel length) on three-dimensional (3D) computed tomography (CT) and graft inclination on magnetic resonance imaging (MRI) after anatomic [...] Read more.
Background and Objectives: The aim of this study is to investigate the femoral tunnel geometry (femoral tunsnel location, femoral graft bending angle, and femoral tunnel length) on three-dimensional (3D) computed tomography (CT) and graft inclination on magnetic resonance imaging (MRI) after anatomic anterior cruciate ligament (ACL) reconstruction using a flexible reamer system. Materials and Methods: A total of 60 patients who underwent anatomical ACL reconstruction (ACLR) using a flexible reamer system were retrospectively reviewed. One day after the ACLR procedure was performed, all patients underwent three-dimensional computed tomography (3D-CT) and magnetic resonance imaging (MRI). The femoral tunnel location, femoral graft bending angle, femoral tunnel length, and graft inclination were assessed. Results: In the 3D-CTs, the femoral tunnel was located at 29.7 ± 4.4% in the posterior to anterior (deep to shallow) direction and at 24.1 ± 5.9% in the proximal to distal (high to low) direction. The mean femoral graft bending angle was 113.9 ± 5.7°, and the mean femoral tunnel length was 35.2 ± 3.1 mm. Posterior wall breakage was observed in five patients (8.3%). In the MRIs, the mean coronal graft inclination was 69.2 ± 4.7°, and the mean sagittal graft inclination was 52.4 ± 4.6°. The results of this study demonstrated that a comparable femoral graft bending angle and longer femoral tunnel length were observed compared with the reported outcomes from previous studies that used the rigid reamer system. Conclusions: ACLR using a flexible reamer system allowed for an anatomic femoral tunnel location and a comparable graft inclination to that of the native ACL. In addition, it achieved a tolerable femoral graft bending angle and femoral tunnel length. Full article
(This article belongs to the Special Issue Cutting-Edge Concepts in Knee Surgery)
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Review

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9 pages, 1299 KiB  
Review
Usefulness of 3-Dimensional Computed Tomography Assessment of Femoral Tunnel after Anterior Cruciate Ligament Reconstruction
by Min-Jeong Kim, Sung-Gyu Moon, Ji-Hee Kang and Dhong-Won Lee
Medicina 2023, 59(10), 1716; https://doi.org/10.3390/medicina59101716 - 26 Sep 2023
Viewed by 989
Abstract
Positioning of the femoral tunnel during anterior cruciate ligament (ACL) reconstruction is the most crucial factor for successful procedure. Owing to the inter-individual variability in the intra-articular anatomy, it can be challenging to obtain precise tunnel placement and ensure consistent results. Currently, the [...] Read more.
Positioning of the femoral tunnel during anterior cruciate ligament (ACL) reconstruction is the most crucial factor for successful procedure. Owing to the inter-individual variability in the intra-articular anatomy, it can be challenging to obtain precise tunnel placement and ensure consistent results. Currently, the three-dimensional (3D) reconstruction of computed tomography (CT) scans is considered the best method for determining whether femoral tunnels are positioned correctly. Postoperative 3D-CT feedback can improve the accuracy of femoral tunnel placement. Precise tunnel formation obtained through feedback has a positive effect on graft maturation, graft failure, and clinical outcomes after surgery. However, even if femoral tunnel placement on 3D CT is appropriate, we should recognize that acute graft bending negatively affects surgical results. This review aimed to discuss the implementation of 3D-CT evaluation for predicting postoperative outcomes following ACL re-construction. Reviewing research that has performed 3D CT evaluations after ACL reconstruction can provide clinically significant evidence of the formation of ideal tunnels following anatomic ACL reconstruction. Full article
(This article belongs to the Special Issue Cutting-Edge Concepts in Knee Surgery)
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Other

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6 pages, 1935 KiB  
Technical Note
Posterior Medial Meniscus Root Repair Using Two Transtibial Tunnels with Modified Mason–Allen Stitches: A Technical Note
by Du-Han Kim, Ki-Cheor Bae, Chang-Jin Yon and Ji-Hoon Kim
Medicina 2023, 59(5), 922; https://doi.org/10.3390/medicina59050922 - 11 May 2023
Viewed by 1396
Abstract
Complete tear of the posterior medial meniscus root can result in a loss of hoop tension and increased contact pressure. Thus, medial meniscus posterior root tear (MMPRT) is increasingly recognized as an important pathology. Although several surgical techniques for MMPRT have recently been [...] Read more.
Complete tear of the posterior medial meniscus root can result in a loss of hoop tension and increased contact pressure. Thus, medial meniscus posterior root tear (MMPRT) is increasingly recognized as an important pathology. Although several surgical techniques for MMPRT have recently been introduced, the ideal technique is not yet established. This technical note is aimed at introducing a novel surgical technique using two transtibial tunnels with modified Mason–Allen stitches in the treatment of MMPRT. Full article
(This article belongs to the Special Issue Cutting-Edge Concepts in Knee Surgery)
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