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Clinical Advances in Hip and Knee Surgery
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Clinical Advances in Hip and Knee Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 5393

Special Issue Editor

Dr. Hyonmin Choe

E-Mail Website
Guest Editor
Department of Orthopaedic Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama 236-0004, Japan
Interests: orthopedic surgery; hip and knee joint diseases; robot surgery; venous thrombosis; periprosthetic joint infection; surgical site infection
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Recent advancements in surgical technologies are remarkable, and hip and knee surgeries are no exception. In joint arthroplasty, the clinical usefulness of computer-assisted surgery, represented by robotic surgery, is leading to reliable outcomes. Molecular biological techniques represented by genetic diagnosis are beginning to be applied in the diagnosis of orthopedic biofilm infections as well as COVID-19 infection. Development of motion analysis technology is expected to contribute to the accurate extraction of patient-specific posture and lead to the establishment of screening for musculoskeletal diseases and tailor-made rehabilitation medicine. The development of regenerative medicine is associated with advanced clinical outcomes in hip and knee surgery. Large-scale research data lead to the development of a preventive protocol on venous thrombosis and surgical site infection, which are serious complications in hip and knee surgery. Despite the onslaught of COVID-19, technologies in hip and knee surgeries are making steady progress. Thus, in this Special Issue titled ‘Clinical Advances in Hip and Knee Surgery’, we are calling for a wide range of papers focusing on such advances in hip and knee surgeries.

Dr. Hyonmin Choe
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. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly 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 2600 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

  • computer-assisted surgery
  • robot surgery
  • artificial intelligence
  • molecular biological techniques
  • genetic diagnosis
  • motion analysis
  • tailor-made rehabilitation
  • regenerative medicine

Published Papers (5 papers)

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Research

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12 pages, 1595 KiB  
Article
Stem Design in Total Hip Arthroplasty Influences Ipsilateral Knee Valgus: A Retrospective Comparative Analysis of 2953 Cases
by Paul Thöne, Michael Stephan Gruber, Harald Kindermann, Walter Gussner, Patrick Sadoghi and Reinhold Ortmaier
J. Clin. Med. 2023, 12(20), 6662; https://doi.org/10.3390/jcm12206662 - 21 Oct 2023
Cited by 1 | Viewed by 1024
Abstract
Background: Total hip arthroplasty (THA) affects the biomechanics of the hip and the patient gait. The stem design influences femoral lever ratios and tissue trauma. Biomechanical changes such as these have the potential to induce knee arthritis. A varus or valgus configuration of [...] Read more.
Background: Total hip arthroplasty (THA) affects the biomechanics of the hip and the patient gait. The stem design influences femoral lever ratios and tissue trauma. Biomechanical changes such as these have the potential to induce knee arthritis. A varus or valgus configuration of knee arthritis is formed by asymmetric loadings. The aim of this study was to evaluate the impact of stem design in THA on knee valgus by comparing a standard implant with an implant with a short stem. Methods: A total of 2953 patients who underwent primary total knee arthroplasty for end-stage osteoarthritis between 2015 and 2021 were included in this retrospective data analysis. Patients were divided into three groups, depending on hip status (straight stem, short stem, and native joint). Leg alignment was distinguished as varus or valgus, and the degree of axial deviation was measured. Descriptive and explorative statistical analyses were performed, with a p value < 0.05 set as significant. Results: Ipsilateral knee valgus occurred significantly more often in patients with straight stems (57.2%) than in those with short stems (29%) and native joints (25.8%) (p < 0.001). Additionally, mean valgus deviation was significantly increased in patients with straight stems (8.9°) compared to those with short stems (6.4°) or native hip joints (6.7°). Both findings were accentuated in women. Conclusions: Previous ipsilateral straight-stem THA is associated with knee valgus deformity, especially in women. Short-stem THA seems to be better suited to restoring physiological biomechanics and preventing the development of valgus osteoarthritis of the ipsilateral knee. Full article
(This article belongs to the Special Issue Clinical Advances in Hip and Knee Surgery)
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10 pages, 1347 KiB  
Article
Contralateral Hip Abductor Muscle Strength Associated with Comfort of Getting into and out of the Car after Total Hip Arthroplasty
by Tetsunari Harada, Satoshi Hamai, Daisuke Hara, Tsutomu Fujita, Daisuke Fujiyoshi, Shinya Kawahara, Ryosuke Yamaguchi, Kenichi Kawaguchi and Yasuharu Nakashima
J. Clin. Med. 2023, 12(17), 5515; https://doi.org/10.3390/jcm12175515 - 25 Aug 2023
Viewed by 630
Abstract
There are no studies that have investigated the characteristics of car use across THA patients, including those who do not drive. This study aimed to evaluate, in THA patients, (1) postoperative car usage, (2) comfort while entering and exiting a car, and (3) [...] Read more.
There are no studies that have investigated the characteristics of car use across THA patients, including those who do not drive. This study aimed to evaluate, in THA patients, (1) postoperative car usage, (2) comfort while entering and exiting a car, and (3) whether lower limb muscle strength affects action comfort. One hundred seventy-two post-THA patients completed the questionnaire in 2020, along with assessments of hip abductor and knee extensor muscle strength before surgery and at discharge. Patients whose overall comfort level was judged as comfortable were defined as the comfort group; others were placed in the discomfort group. Of the 172 patients, 161 reported car usage at a mean of 5.6 years after THA. Of these, 114 and 47 patients were placed in the comfort and discomfort groups, respectively. Patients in the discomfort group were three times more likely to experience discomfort using the contralateral side door than the surgical side door, and about twice as many patients experienced discomfort when entering as when exiting. Lower preoperative contralateral hip abductor muscle strength was the only independent predictor for discomfort. The take-home messages were that prevention of contralateral-side weakness may improve comfort during the action after THA. Full article
(This article belongs to the Special Issue Clinical Advances in Hip and Knee Surgery)
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8 pages, 1159 KiB  
Article
Sequential Intraoperative Evaluation of Rotational Stability of Cementless Stem in Total Hip Arthroplasty: A Broach-Based Study
by Sakae Kinoshita, Koichi Kinoshita, Tetsuya Sakamoto, Hajime Seo, Masahiro Suzuki and Takuaki Yamamoto
J. Clin. Med. 2023, 12(17), 5444; https://doi.org/10.3390/jcm12175444 - 22 Aug 2023
Viewed by 1013
Abstract
In cementless total hip arthroplasty, the rotational stability of the stem is generally confirmed in a one-time manual evaluation by the surgeon. This study was performed to evaluate the sequential intraoperative changes in rotational stability using a torque wrench. Primary total hip arthroplasty [...] Read more.
In cementless total hip arthroplasty, the rotational stability of the stem is generally confirmed in a one-time manual evaluation by the surgeon. This study was performed to evaluate the sequential intraoperative changes in rotational stability using a torque wrench. Primary total hip arthroplasty was performed on 52 consecutive hips using a single wedge stem design. Intraoperative evaluation of rotational stability was uniformly performed using a torque wrench. Evaluations were performed immediately after broach insertion and immediately before the final insertion of the stem (after placement of the acetabular cup). Immediately after the insertion of the broach, rotational stability was checked and confirmed to be fully stabilized using a torque wrench in all cases, and the stability was maintained in 17 of 52 (33%) hips immediately before the final insertion of the stem. Among the hips showing instability, 11 of 35 (31%) broaches were upsized, while the remaining 24 hips achieved stabilization through deeper insertion of the broach. In conclusion, the rotational stability achieved immediately after the insertion of the broach was not necessarily maintained during surgery, indicating that rotational stability may need to be checked at multiple time points intraoperatively. Full article
(This article belongs to the Special Issue Clinical Advances in Hip and Knee Surgery)
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13 pages, 2293 KiB  
Article
Change in Descriptive Kinematic Parameters of Patients with Patellofemoral Instability When Compared to Individuals with Healthy Knees—A 3D MRI In Vivo Analysis
by Markus Siegel, Philipp Maier, Elham Taghizadeh, Andreas Fuchs, Tayfun Yilmaz, Hans Meine, Hagen Schmal, Thomas Lange and Kaywan Izadpanah
J. Clin. Med. 2023, 12(5), 1917; https://doi.org/10.3390/jcm12051917 - 28 Feb 2023
Cited by 4 | Viewed by 1352
Abstract
Background: Patellofemoral instability (PFI) leads to chronic knee pain, reduced performance and chondromalacia patellae with consecutive osteoarthritis. Therefore, determining the exact patellofemoral contact mechanism, as well as the factors leading to PFI, is of great importance. The present study compares in vivo patellofemoral [...] Read more.
Background: Patellofemoral instability (PFI) leads to chronic knee pain, reduced performance and chondromalacia patellae with consecutive osteoarthritis. Therefore, determining the exact patellofemoral contact mechanism, as well as the factors leading to PFI, is of great importance. The present study compares in vivo patellofemoral kinematic parameters and the contact mechanism of volunteers with healthy knees and patients with low flexion patellofemoral instability (PFI). The study was performed with a high-resolution dynamic MRI. Material/Methods: In a prospective cohort study, the patellar shift, patella rotation and the patellofemoral cartilage contact areas (CCA) of 17 patients with low flexion PFI were analyzed and compared with 17 healthy volunteers, matched via the TEA distance and sex, in unloaded and loaded conditions. MRI scans were carried out for 0°, 15° and 30° knee flexion in a custom-designed knee loading device. To suppress motion artifacts, motion correction was performed using a moiré phase tracking system with a tracking marker attached to the patella. The patellofemoral kinematic parameters and the CCA was calculated on the basis of semi-automated cartilage and bone segmentation and registrations. Results: Patients with low flexion PFI showed a significant reduction in patellofemoral CCA for 0° (unloaded: p = 0.002, loaded: p = 0.004), 15° (unloaded: p = 0.014, loaded: p = 0.001) and 30° (unloaded: p = 0.008; loaded: p = 0.001) flexion compared to healthy subjects. Additionally, patients with PFI revealed a significantly increased patellar shift when compared to volunteers with healthy knees at 0° (unloaded: p = 0.033; loaded: p = 0.031), 15° (unloaded: p = 0.025; loaded: p = 0.014) and 30° flexion (unloaded: p = 0.030; loaded: p = 0.034) There were no significant differences for patella rotation between patients with PFI and the volunteers, except when, under load at 0° flexion, PFI patients showed increased patellar rotation (p = 0.005. The influence of quadriceps activation on the patellofemoral CCA is reduced in patients with low flexion PFI. Conclusion: Patients with PFI showed different patellofemoral kinematics at low flexion angles in both unloaded and loaded conditions compared to volunteers with healthy knees. Increased patellar shifts and decreased patellofemoral CCAs were observed in low flexion angles. The influence of the quadriceps muscle is diminished in patients with low flexion PFI. Therefore, the goal of patellofemoral stabilizing therapy should be to restore a physiologic contact mechanism and improve patellofemoral congruity for low flexion angles. Full article
(This article belongs to the Special Issue Clinical Advances in Hip and Knee Surgery)
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Review

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11 pages, 1730 KiB  
Review
Accuracy of Albumin, Globulin, and Albumin–Globulin Ratio for Diagnosing Periprosthetic Joint Infection: A Systematic Review and Meta-Analysis
by Hyonmin Choe, Emi Kamono, Koki Abe, Yuta Hieda, Hiroyuki Ike, Ken Kumagai, Naomi Kobayashi and Yutaka Inaba
J. Clin. Med. 2023, 12(24), 7512; https://doi.org/10.3390/jcm12247512 - 5 Dec 2023
Cited by 1 | Viewed by 841
Abstract
Periprosthetic joint infection (PJI) is one of the most intractable orthopedic diseases, partly because of the difficulty in differentiating septic from aseptic conditions. We aimed to evaluate and consolidate the diagnostic accuracy of the quantitative assessment of serum albumin (Alb), globulin (Glb), and [...] Read more.
Periprosthetic joint infection (PJI) is one of the most intractable orthopedic diseases, partly because of the difficulty in differentiating septic from aseptic conditions. We aimed to evaluate and consolidate the diagnostic accuracy of the quantitative assessment of serum albumin (Alb), globulin (Glb), and albumin–globulin ratio (AGR), alone or in combination with the inflammatory marker, C-reactive protein (CRP), for PJI. We searched the PubMed, CINAHL, and Cochrane Library databases for studies that quantitatively measured Alb, Glb, or AGR for the diagnosis of PJI up until the 30 April 2023. A total of 2339 patients were included from 10 studies, including 845 patients with a definitive diagnosis of PJI and 1494 with non-PJI. The pooled sensitivity, specificity, and area under the curve (AUC) in the summary receiver-operating characteristic curve were as follows: 0.625, 0.732, and 0.715 for Alb; 0.815, 0.857, and 0.887 for Glb; 0.753, 0.757, and 0.875 for AGR; 0.788, 0.837, and 0.876 for CRP; 0.879, 0.890, and 0.917 for the CRP–Alb ratio; and 0.845, 0.855, and 0.908 for the CRP–AGR ratio. Serum Alb, Glb, and AGR levels are feasible and accurate diagnostic markers for PJI, and the combination of these markers with CRP levels may potentially improve preoperative serum diagnostic accuracy. Future prospective studies are required to verify these findings because of the small numbers of included studies. Full article
(This article belongs to the Special Issue Clinical Advances in Hip and Knee Surgery)
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