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Separate 2-Incision Harvesting Technique for Bone-Patellar Tendon-Bone Autograft Using a Circular Hollow Burr in Arthroscopic Anterior Cruciate Ligament Reconstruction

Tue, 31 Dec 2024 15:00:00 GMT

Title: Separate 2-Incision Harvesting Technique for Bone-Patellar Tendon-Bone Autograft Using a Circular Hollow Burr in Arthroscopic Anterior Cruciate Ligament Reconstruction All Author(s): Hyung-Suk Choi; Byung-Ill Lee; Kyoung-Dai Min; Jun-Bum Kim; Sai-Won Kwon; Yong-Beom Kim; Gi-Won Seo; Hyun-Uk Lee Abstract: Bone-patellar tendon-bone autografts are the gold standard for anterior cruciate ligament reconstruction but are associated with donor site morbidity. This Technical Note describes a separate vertical 2-incision approach using a circular hollow burr for bone-patellar tendon-bone autograft harvesting. The technique minimizes soft tissue and bone damage, reduces anterior knee pain and nerve injury, and improves cosmetic outcomes. The oscillating circular hollow burr enables precise bone plug extraction, enhancing graft integration and stability while protecting the articular cartilage. Our unique technique suggests a reliable alternative to traditional techniques, as well as provides a clinically effective and cosmetically favorable option, thus reducing donor site morbidity while minimizing risks associated with the harvesting procedure.

A prospective pilot study on plasma amyloid beta oligomers and postoperative delirium

Tue, 31 Dec 2024 15:00:00 GMT

Title: A prospective pilot study on plasma amyloid beta oligomers and postoperative delirium All Author(s): YoungSoon Yang; Ki Jin Jung; Yong Tae Kwak Abstract: Introduction: Postoperative delirium (POD) is common in older adults and has been linked to Alzheimer's disease (AD). Plasma amyloid-β oligomers (AβOs) may clarify this relationship. We evaluated whether preoperative AβO burden is associated with POD severity. Methods: In this single-center prospective pilot study, we enrolled 22 patients aged ≥65 years undergoing hip or knee arthroplasty under general anesthesia. Blood was drawn preoperatively and postoperatively to quantify oligomerized amyloid-β using the multimer detection system (MDS-Oaβ). POD was assessed with the Korean version of the Delirium Rating Scale-98 (K-DRS-98). Group comparisons and correlations examined associations between MDS-Oaβ and POD. Results: Eleven of 22 patients developed POD. Those with POD were older and had higher preoperative MDS-Oaβ than those without POD (0.81 vs 0.56 ng/mL). There was no significant perioperative change in MDS-Oaβ, suggesting surgery or anesthesia did not alter the plasma Aβ oligomerization tendency. Within the POD group, preoperative MDS-Oaβ correlated with both K-DRS-98 severity and total scores. Discussion: In this pilot cohort, higher preoperative AβO burden was associated with the occurrence and severity of POD, while perioperative factors did not measurably affect AβO levels. These findings support a potential mechanistic link between AD-related pathology and POD. Given the small sample (N=22), estimates are imprecise and hypothesis-generating; validation in larger, multicenter studies is required before clinical application.

Clinical and Radiological Outcomes of Revision Anterior Cruciate Ligament Reconstruction Using a Quadriceps Tendon Autograft with a Bone Block: A Single-Center Case Series

Tue, 31 Dec 2024 15:00:00 GMT

Title: Clinical and Radiological Outcomes of Revision Anterior Cruciate Ligament Reconstruction Using a Quadriceps Tendon Autograft with a Bone Block: A Single-Center Case Series All Author(s): Dhong Won Lee; Sung Gyu Moon; Ji Hee Kang; Seung Ik Cho; Woo Jong Kim Abstract: Background and Objectives: Revision anterior cruciate ligament reconstruction (ACLR) is demanding and yields inferior outcomes compared with primary procedures. The quadriceps tendon (QT) autograft with bone block has biomechanical and biological advantages though clinical evidence in revision remains limited. This study evaluated the clinical and radiological outcomes of revision ACLR using bone-block QT autograft in young, active patients. Materials and Methods: A case series with a level of evidence of 4. Thirty-four patients (28 men, 6 women; mean age, 27.2 ± 5.8 years) who underwent revision ACLR with a bone-block QT autograft between 2021 and 2023 were retrospectively reviewed. The mean follow-up was 37.4 ± 3.2 months. Clinical assessments included the Lysholm, International Knee Documentation Committee (IKDC) subjective, and Tegner activity scores, along with isokinetic strength testing. Objective stability was evaluated using pivot shift grading and Telos stress radiography. Radiological analyses included 3D computed tomography for tunnel positioning and magnetic resonance imaging for tunnel widening. Perioperative and postoperative complications were recorded. Results: All clinical outcomes improved significantly from baseline to 2-year follow-up: Lysholm (62.7 ± 9.6 to 87.1 ± 10.3), IKDC (59.0 ± 10.8 to 79.5 ± 11.1), and Tegner (3.5 ± 1.2 to 5.6 ± 1.3; all p < 0.001). However, the Tegner score remained lower than the pre-injury level (6.1 ± 1.4; p = 0.035). At the final follow-up, 91.2% of the patients had returned to sports, with 59% resuming sports at their pre-injury level or higher. Side-to-side anterior laxity decreased from 8.5 ± 1.7 mm to 1.4 ± 1.1 mm on Telos stress radiography (p < 0.001). Preoperatively, 82% of patients demonstrated high grade pivot shift (≥grade 2), which improved to 91% graded as negative or grade 1 at final follow-up (p < 0.001). Isokinetic evaluation showed improvements in quadriceps (28.7% ± 12.5% to 12.4% ± 8.1%) and hamstring (18.3% ± 9.7% to 8.9% ± 6.5%) deficit (both p < 0.001). MRI demonstrated minimal tunnel widening (tibia, +1.3 ± 0.9 mm, p = 0.012; femur, +0.3 ± 0.6 mm, p = 0.148). Three complications (8.8%) were observed: one cyclops lesion, one transient extension deficit, and one graft rupture. No patellar fractures, septic arthritis, or revision procedures occurred during the follow-up period. Conclusions: Bone-block QT autografts provide a reliable option for revision ACLR, yielding functional improvement, restored stability, and minimal donor-site morbidity, with low complications. These findings support their consideration as the preferred graft choice for young active patients needing revision reconstruction.

Corrigendum to "Bidirectional barbed polydioxanone filament insertion in vastus medialis oblique muscle for knee osteoarthritis improvement" [The Knee 55 (2025) 1-11]

Tue, 31 Dec 2024 15:00:00 GMT

Title: Corrigendum to "Bidirectional barbed polydioxanone filament insertion in vastus medialis oblique muscle for knee osteoarthritis improvement" [The Knee 55 (2025) 1-11] All Author(s): Sai-Won Kwon; Sung-Woo Choi; Byung-Hak Oh; Chang-Hyun Kim; Byung-Ryul Lee; Hyoung-Ye Kim; Mi-Ae Nam; Kang-San Lee; Dong-Woo Lee Abstract: No abstract available