Functional outcomes and complications experienced by adult patients who underwent iliac crest bone grafting were evaluated to assess the effect of bone grafts on patient function. In addition to retrospective chart reviews, patients completed the Sickness Impact Profile and a detailed questionnaire on pain. One hundred ninety-two patients met study inclusion criteria. Major complications were recorded in four (2.4%) patients in whom infections developed requiring readmission. Thirty-seven (21.8%) patients had minor complications. One hundred nineteen of 170 patients were available for followup; of these 119 patients, 87 (73.1%) returned completed questionnaires. Thirty-three of 87 (37.9%) patients reported pain 6 months postoperatively. The incidence of pain decreased with time, with 16 of 87 (18.7%) patients continuing to report pain more than 2 years postoperatively. Proportionately more spine patients reported pain at all time points. The mean Sickness Impact Profile score for patients completing questionnaires was nine, suggesting most patients were functioning well 2 years postoperatively. The morbidity of iliac crest grafting remains substantial. Pain symptoms in this study sample seemed to last longer in more patients than earlier series have indicated. Minimizing muscle dissection around donor sites and the advent of bone graft substitutes may help alleviate these problems.

Autogenous iliac crest bone graft : Complications and functional assessment : Orthopaedic trauma education: A tribute to the university of California, Davis orthopaedic trauma fellowship

Update This article was updated on January 4, 2023, because of a previous error, which was discovered after the preliminary version of the article was posted online. On page 16, in Figure 5, the x-axis that had read “P<0.0086” now reads “KSS Pain (p=0.02),” and the value for the MS group that had read “48.9” now reads “48.8.” This article was further updated on January 6, 2022, because of a previous error. On page 13, in the section entitled “Results,” the sentence that had read “However, when only the subset of female subjects was considered, the MS group demonstrated significantly less anteroposterior laxity in 90° of flexion than the MS group (2.3 versus 5.4 mm; p = 0.008).” now reads “However, when only the subset of female subjects was considered, the MS group demonstrated significantly less anteroposterior laxity in 90° of flexion than the PS group (2.3 versus 5.4 mm; p = 0.008).” An erratum has been published: J Bone Joint Surg Am. 2023 Feb 15;105(4):e15. Background: Stability in mid-flexion is important for satisfactory clinical outcomes following total knee arthroplasty (TKA). The purpose of the present study was to compare the anteroposterior stability of knees that had been treated with a posterior-stabilized (PS) device or a medial-stabilized (MS) device. We hypothesized that mid-flexion laxity would be greater in the PS group and that clinical outcome scores would be better for the group with lower laxity. Methods: Sixty-three patients who had been randomly selected from a larger randomized, prospective, blinded clinical trial underwent primary TKA with either a PS implant (n = 30) or an MS implant (n = 33). Range of motion, the Knee Society Score (KSS), and the Forgotten Joint Score (FJS) were collected, and anteroposterior laxity with the knee in 45° and 90° of flexion was evaluated with stress radiographs. Results: In 45° of flexion, the MS group demonstrated significantly less total anteroposterior displacement than the PS group (mean, 3.6 versus 16.5 mm; p ≤ 0.0001). In 90° of flexion, the total anteroposterior displacement was not significantly different for the 2 groups when both male and female patients were included (mean, 3.9 versus 5.9; p = 0.07). However, when only the subset of female subjects was considered, the MS group demonstrated significantly less anteroposterior laxity in 90° of flexion than the PS group (2.3 versus 5.4 mm; p = 0.008). The groups did not differ significantly in terms of preoperative age, body mass index, sex distribution, FJS, KSS, or range of motion, and they also did not differ in terms of postoperative FJS or range of motion. However, all 33 patients in the MS group returned to sports as indicated in question 12 of the FJS, compared with 19 subjects in the PS group (p = 0.0001). The postoperative KSS Pain, Pain/Motion, and Function scores were all significantly higher in the MS group than the PS; specifically, the mean KSS Pain score was 48.8 in the MS group, compared with 44.8 in the PS group (p = 0.02); the mean KSS Pain/Motion score was 98.4 in the MS group, compared with 89.5 in the PS group (p < 0.0001); and the mean KSS Function score was 95.5 in the MS group, compared with 85.7 in the PS group (p = 0.003). Conclusions: Mid-flexion laxity was greater in patients with PS implants than in those with MS implants, and laxity in 90° was greater in the subset of female patients in the PS group. The decreased laxity observed in the MS group correlated with higher KSS Pain, Pain/Motion, and Function scores as well as with a higher rate of return to sports activities. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Mid-Flexion, Anteroposterior Stability of Total Knee Replacement Implanted with Kinematic Alignment

Reference standards for stress radiography measurements in knee ligament injury and instability: a systematic review.

Current research focused on clinical outcomes suggests that lateral extra-articular procedures (LEAPs) can reduce rotational instability and graft failure rates in primary anterior cruciate ligament reconstructions (ACLRs). Limited studies have investigated the functional outcomes after LEAPs, including patient-reported outcome measures, sports participation, and physical performance. To conduct a systematic literature review and meta-analysis to determine whether the addition of a LEAP to an ACLR results in superior functional and clinical outcomes as compared with an isolated ACLR. Systematic review and meta-analysis; Level of evidence, 1. Five databases were searched to identify randomized controlled trials comparing clinical and functional outcomes after the addition of LEAPs to an isolated primary ACLR. Study selection was performed in accordance with the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses). Assessment of methodological quality for included studies was undertaken using the Cochrane Risk of Bias 2 tool for randomized controlled trials. Studies were eligible for meta-analysis if an outcome measure utilizing similar time points was present across ≥2 studies and reported in mean difference or standard deviation. Meta-analysis of 10 studies showed that the addition of LEAPs to an ACLR can reduce rates of rotatory instability (risk ratio, 1.45 [95% CI, 1.17-1.79]; P = .0006; I2 = 0%) and graft rupture (risk ratio, 0.21 [95% CI, 0.08-0.55]; P < .001; I2 = 0%). As supported by studies eligible for meta-analysis, this review showed that the addition of LEAPs to an ACLR can reduce rotatory instability. Short-term morbidity, including increased pain, joint stiffness, and muscle weakness, as compared with isolated ACLRs was resolved by 12 months after surgery. ACLR in combination with a LEAP results in superior clinical outcomes when compared with an isolated ACLR. Despite early postoperative outcomes concerning pain and function favoring isolated ACLRs, any negative effects were not still observed 6 months after surgery. A conclusion around the correlation between LEAPs and accelerated knee osteoarthritis could not be drawn, owing to the lack of long-term prospective studies available. 

Does the Addition of a Lateral Extra-articular Procedure to a Primary Anterior Cruciate Ligament Reconstruction Result in Superior Functional and Clinical Outcomes? A Systematic Review and Meta-analysis of Randomized Controlled Trials.


 Background: We think reduction forced toward the posterior side during graft fixation could be helpful in reducing the side-to-side difference (STSD) after ACL reconstruction. The purpose of our study was to compare the clinical and radiological outcomes of graft fixation with or without a posterior draw during anterior cruciate ligament (ACL) reconstruction surgery.Methods: Among 110 patients who underwent primary arthroscopic ACL reconstruction between January 2017 and August 2020, 76 patients underwent surgery without a posterior draw (non-draw group) and 34 patients underwent ACL reconstruction with posterior draw (draw group). Results of the Lachman test, pivot-shift test, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, Lysholm score, International Knee Documentation Committee (IKDC) subjective score, and STSD on stress radiography were compared between the two groups.Results: The postoperative WOMAC index, Lysholm score, and IKDC subjective score were similar with the draw group. Postoperative STSD (non-draw group vs draw group, 2.4 ± 2.2 vs 2.0 ± 2.2, P = 0.319) and change of STSD (preoperative STSD vs postoperative STSD, 3.5 ± 3.5 vs 4.3 ± 4.4, P = 0.295) were not superior in the draw group.Conclusion: Graft fixation with a posterior draw was not helpful in enhancing postoperative stability during ACL reconstruction. Postoperative clinical outcomes were also not superior in the draw group.Study design: Level III, retrospective comparative study.

/pdf/the-effect-of-posterior-draw-during-graft-fixation-of-17x4fecv.pdf

The Effect of Posterior Draw During Graft Fixation of Anterior Cruciate Ligament Reconstruction

Background:After posterior cruciate ligament injury, stress radiography is a common method of quantifying posterior instability, defined as the side-to-side difference in posterior tibial displacem...

https://journals.sagepub.com/doi/pdf/10.1177/2325967121989252

Clinically Reliable Knee Flexion Angle Measured on Stress Radiography for Quantifying Posterior Instability in Posterior Cruciate Ligament Injury

To compare the clinical, radiographic, and second-look arthroscopic outcomes between double-bundle (DB) anterior cruciate ligament (ACL) reconstruction (DB group) and combined single-bundle (SB) ACL and anterolateral ligament (ALL) reconstruction (SB + ALL group) by a prospective randomized controlled trial.From May 2019 to June 2020, 84 patients were enrolled in this study. Among them, 10 were lost to follow-up. Thirty-six and 38 patients were successfully allocated to the DB (mean follow up 27.3 ± 4.2 months) and SB + ALL groups (27.2 ± 4.5 months), respectively. The preoperative and postoperative Lachman test, pivot shift test, anterior translation on stress radiographs, KT-2000 arthrometer, Lysholm score, International Knee Documentation Committee score, and Tegner activity score were evaluated and compared. Graft continuity was evaluated using postoperative magnetic resonance imaging (MRI) (32 and 36 patients underwent MRI in the DB and SB + ALL groups at 7.4 ± 3.2 and 7.5 ± 2.9 months after surgery, respectively), and second-look examinations (second-look examination and tibial screw removal were performed concomitantly when patients (1) had tibial screw-related irritation or (2) needed the screws removed, 28 and 23 patients underwent examinations in the DB and SB + ALL groups at 24.0 ± 6.8 and 24.9 ± 8.1 months after surgery, respectively). All measurements were compared between the groups.Postoperative clinical outcomes significantly improved in both groups. (All variables showed P < .001) No statistically different outcomes were found between the 2 groups. Additionally, postoperative graft continuity on MRI and second-look examinations were not different between the 2 groups.The DB and SB + ALL groups showed similar postoperative clinical, radiographic, and second-look arthroscopic outcomes. Both groups showed excellent postoperative stability and clinical outcomes compared with the preoperative measurements.Level II. 

Single bundle anterior cruciate ligament with anterolateral ligament reconstruction yields similar clinical and radiographic results at minimum 2-year follow-up versus double bundle anterior cruciate ligament reconstruction: A prospective randomized controlled trial.

Bone graft is required in various surgical procedures. Although autograft is the gold standard, it has limited availability. Various compounds have been proposed as alternatives such as biphasic calcium phosphate (BCP), which is the most widely used compound. The newly synthesized microporous sphere-shaped BCP has the advantage of increasing contact surface, and it can induce the formation of microbone structures. A putty-type contains the addition of a fluid carrier to the sphere-shaped BCP and can be easily used for a small orifice large bone defect. To compare the widely used BCP products, new bone formation and residual graft materials (RGM) were evaluated for 6 and 12 weeks in a rabbit calvarial bone defect model. Although existing BCP products and the microporous sphere-type product did not differ significantly with respect to new bone formation and RGM, the putty-type product was largely washed out and had low new bone formation at 6 and 12 weeks. Overall, the results suggest that microporous sphere-shaped BCP showed similar bone formation capability to existing products and was able to maintain higher initial mechanical stability.

Efficacy of bone formation of microporous sphere-shaped biphasic calcium phosphate in a rabbit skull bone defect model.

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Kyeu Baek Kwon

Author Tools

Chat about Author

Papers

Clinically Reliable Knee Flexion Angle Measured on Stress Radiography for Quantifying Posterior Instability in Posterior Cruciate Ligament Injury

Single bundle anterior cruciate ligament with anterolateral ligament reconstruction yields similar clinical and radiographic results at minimum 2-year follow-up versus double bundle anterior cruciate ligament reconstruction: A prospective randomized controlled trial.

Efficacy of bone formation of microporous sphere-shaped biphasic calcium phosphate in a rabbit skull bone defect model.