The advances in the knowledge of anatomy, surgical techniques, and fixation devices have led to the improvement of anterior cruciate ligament (ACL) reconstruction over the past 10 years. Nowadays, double bundle and anatomical single bundle ACL reconstruction that more closely restores the normal anatomy of the ACL are becoming popular. Although there is still no definite conclusion whether double bundle ACL reconstruction provides better clinical results than single bundle reconstruction, the trend has shifted to anatomic reconstruction regardless of single bundle or double bundle techniques. We could not find any significant differences in the clinical outcomes and stability after ACL reconstruction according to the type of graft or fixation device. Therefore, surgeons should select an ideal ACL reconstruction according to the patient's condition and surgeon's experience.

Targeted cell delivery by a magnetically actuated microrobot with a porous structure is a promising technique to enhance the low targeting efficiency of mesenchymal stem cell (MSC) in tissue regeneration. However, the relevant research performed to date is only in its proof-of-concept stage. To use the microrobot in a clinical stage, biocompatibility and biodegradation materials should be considered in the microrobot, and its efficacy needs to be verified using an in vivo model. In this study, we propose a human adipose–derived MSC–based medical microrobot system for knee cartilage regeneration and present an in vivo trial to verify the efficacy of the microrobot using the cartilage defect model. The microrobot system consists of a microrobot body capable of supporting MSCs, an electromagnetic actuation system for three-dimensional targeting of the microrobot, and a magnet for fixation of the microrobot to the damaged cartilage. Each component was designed and fabricated considering the accessibility of the patient and medical staff, as well as clinical safety. The efficacy of the microrobot system was then assessed in the cartilage defect model of rabbit knee with the aim to obtain clinical trial approval.

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Purpose The purpose of this study was to assess, in anterior cruciate ligament (ACL)-injured and -uninjured population, tibial plateau anatomic variables [medial and lateral tibial plateau slopes (MTPS and LTPS) and medial tibial plateau depth (MTPD)] on conventional magnetic resonance imaging (MRI) using a novel combined method and to determine whether these variables are risk factors for ACL injury. Methods Seventy-three isolated ACL-injury patients (20 women and 53 men) were compared with 51 control group patients (19 women and 32 men). Results The combined method had very high interrater and intrarater reliability compared with previously described methods. LTPS was significantly steeper in the overall injured group and injured men compared with the control group, with odds ratio (OR) of 3.031 and 5.89, respectively. Women with ACL injury had significantly shallower MTPD than uninjured women, with OR of 4.13. Conclusions We conclude that the new combined method is accurate and reproducible for assessing the tibial plateau anatomy. Women with shallower MTPD and men with steeper LTPS are at higher risk of sustaining ACL injury. Overall, steeper LTPS is a significant risk factor for sustaining ACL injury.

Second-look arthroscopic findings at 12 months postoperatively after microfracture for osteochondral lesions of the talus revealed that 40% of lesions were incompletely healed. Nevertheless, the majority of patients achieved a good clinical outcome. Furthermore, postoperative clinical scores were found to be correlated with ICRS repair grades.

BackgroundThis study compared clinical and radiological results between robotic total knee arthroplasty (TKA) and conventional TKA with a cruciate-retaining implant at 10-year follow-up. The hypothesis was that robotic TKA would allow for more accurate leg alignment and component placement, and thus enhance clinical and radiological results and long-term survival rates.MethodsA total of 113 primary TKAs performed using a cruciate-retaining implant in 102 patients from 2004 to 2007 were reviewed retrospectively. Of the 113 TKAs, 71 were robotic TKAs and 42 were conventional TKAs. Clinical outcomes (visual analogue scale pain score, Hospital for Special Surgery score, Western Ontario and McMaster University score, range of motion, and complications), radiological outcomes, and long-term survival rates were evaluated at a mean follow-up of 10 years.ResultsClinical outcomes and long-term survival rates were similar between the two groups. Regarding the radiological outcomes, the robotic TKA group had significantly fewer postoperative leg alignment outliers (femoral coronal inclination, tibial coronal inclination, femoral sagittal inclination, tibial sagittal inclination, and mechanical axis) and fewer radiolucent lines than the conventional TKA group.ConclusionsBoth robotic and conventional TKAs resulted in good clinical outcomes and postoperative leg alignments. Robotic TKA appeared to reduce the incidence of leg alignment outliers and radiolucent lines compared to conventional TKA.

We studied 58 knees that underwent anterior cruciate ligament (ACL) reconstruction using a patella tendon autograft. The mean age at reconstruction was 30.4 (18-58) years, and the average follow-up was 11.2 (8.6-13.8) years. The presence of osteoarthritis was assessed radiographically using Kellgren and Lawrence's classification. Osteoarthritis was detected in the medial compartment in 25 cases and in the lateral compartment in 14 cases. Significant independent predictors of osteoarthritis were: accompanying meniscal injury [odds ratio (OR) 9.19), p<0.001], an interval of more than 6 months from injury to reconstruction (OR 4.77, p=0.021), and age more than 25 years at reconstruction (OR 3.37, p=0.034). However, no statistically significant correlation was found between the development of osteoarthritis and clinical outcome or radiological stability.

The purpose of the present study was to evaluate the outcomes of arthroscopic microfracture for isolated osteochondral lesions of the talus without combined lesions, in patients of less than 50 years old with lesions of <1.5 cm(2). Thirty-five patients (35 ankles) with isolated osteochondral lesions of the talus were treated by arthroscopic microfracture. There were 27 men and 8 women of average age 35 years (range 17-50) and mean body mass index (BMI) 25 kg/m(2) (range 20-34) at the time of surgery. Clinical outcome evaluations were performed at a mean follow-up of 33 months. Overall results, as determined using American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scores, were excellent in 16 (46%), good in 15 (43%), and fair in 4 (11%). Mean AOFAS scores improved from 63 points (range 52-77) preoperatively to 90 points (range 73-100) at final follow-up, median Ankle Activity Score (AAS) from 3 points (range 1-5) to 6 points (range 3-8), mean Visual Analogue Scale (VAS) scores from 7 points (range 5-8) to 2 points (range 0-5), and mean Short Form-36 scores showed improvements in physical function, role limitation, bodily pain, social function, and general health (P < 0.05). In terms of prognostic factors, a longer symptom duration was found to negatively affect outcome, as determined by AOFAS scores, AAS, and VAS scores. Arthroscopic microfracture for isolated osteochondral lesions of the talus is a safe and effective procedure, which provides good clinical outcomes in the majority of patients.