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1.
Clin Orthop Surg ; 15(5): 740-751, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37811518

RESUMO

Background: There is no consensus established on postoperative rehabilitation after medial meniscus posterior root tear (MMPRT) repair, including when and how physicians can apply range of motion (ROM) exercise, weight-bearing (WB), brace use, and return to sports (RTS). The purpose of this study was to systematically review the literature on postoperative rehabilitation characteristics of MMPRT repair regarding ROM, WB, brace use, and RTS. Methods: A literature search was performed using the Medline/PubMed, Cochrane Central Register of Controlled Trials, and Embase databases. The inclusion criteria were English language, human clinical studies, and studies describing rehabilitation protocols after MMPRT repair such as ROM, WB, brace use, and RTS. Abstracts, case reports, cohort studies, controlled laboratory studies, human cadaveric or animal studies, systematic reviews, and meta-analyses were excluded. Results: Thirteen studies were included. Of the 12 ROM studies, ROM was started immediately within 1 or 2 days after operation in 6 studies and after 2 to 3 weeks of knee immobilization in the rest. Of the 13 WB studies, partial weight-bearing was initiated 1 to 4 weeks after operation in 8 studies and 6 weeks in the rest. Of the 9 brace studies, patients were immobilized by a splint for 2 weeks in 3 studies, and in the rest, a brace with full extension was applied for 3 to 6 weeks after several days of splint application. Of the 7 RTS studies, RTS was allowed at 6 months in 6 studies and 5 to 7 months in 1 study. Conclusions: This systematic review revealed conservative rehabilitation protocols were more widely adapted as ROM and WB were restricted at certain degrees during postoperative periods in most protocols analyzed. However, it is impossible to identify a consensus on rehabilitation protocols as the protocols analyzed in this review were distinct each other and heterogeneous. In the future, a well-designed comparative study among different rehabilitation protocols is essential to establish a consensus.


Assuntos
Artroplastia do Joelho , Meniscos Tibiais , Humanos , Meniscos Tibiais/cirurgia , Volta ao Esporte , Ruptura/cirurgia , Suporte de Carga
2.
Clin Orthop Surg ; 15(3): 402-409, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37274499

RESUMO

Background: Lower limb balance ability is reduced after anterior cruciate ligament reconstruction (ACLR). However, the recovery of balance based on functional test scores after ACLR is not known because the correlation between balance and clinical scores remains unclear. We aimed to analyze the correlation between lower limb balance assessed by functional test and clinical knee test scores after ACLR. Methods: We evaluated lower limb balance using the anterior-posterior stability index (APSI) of the Biodex Balance System (BBS). Patients underwent clinical tests to evaluate the knee, including the Tegner activity score, International Knee Documentation Committee (IKDC) subjective score, Lysholm score, and KT-2000 arthrometer measurement, hamstring per quadriceps muscle strength ratio at 60°/sec (HQ ratio), and functional performance tests (single-leg hop and single-leg vertical jump tests) 1 year after ACLR. We used a paired t-test to compare continuous preoperative and postoperative variables and Pearson's correlation coefficient to determine the relationship between BBS-APSI and clinical scores. Results: Forty-eight patients (35 men and 13 women; mean age, 28.9 ± 8.3 years) were included. The follow-up period and BBS-APSI were 12.4 ± 2.0 months and 0.9 ± 0.4, respectively. Tegner activity score, IKDC subjective score, Lysholm score, and KT-2000 arthrometer measurement improved significantly postoperatively (p < 0.001). BBS-APSI was correlated with the Tegner activity score (r = -0.335, p = 0.020), IKDC subjective score (r = -0.301, p = 0.037), Lysholm score (r = -0.323, p = 0.025), single-leg hop test results (r = -0.300, p = 0.038), and single-leg vertical jump test results (r = -0.336, p = 0.019). There was no correlation between KT-2000 arthrometer measurement and HQ ratio. Conclusions: BBS-APSI was correlated with functional performance test scores after ACLR, rendering the BBS-APSI as a useful assessment tool to evaluate postoperative functional recovery. Continuously improving balance after ACLR could be useful for functional recovery after surgery.


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Instabilidade Articular , Masculino , Humanos , Feminino , Adulto Jovem , Adulto , Resultado do Tratamento , Articulação do Joelho/cirurgia , Escore de Lysholm para Joelho , Extremidade Inferior/cirurgia , Instabilidade Articular/cirurgia , Reconstrução do Ligamento Cruzado Anterior/métodos , Lesões do Ligamento Cruzado Anterior/cirurgia
3.
PLoS One ; 18(6): e0287222, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37347765

RESUMO

This study aimed to assess the safety and effectiveness of the highly cross-linked hyaluronic acid-LBSA0103-in patients with knee osteoarthritis (OA) as per the prescribing information (PI) in South Korea. A total of 3,140 subjects aged ≥19 years were enrolled in this post-marketing surveillance (PMS) study from 2013 to 2019. The subjects received one or two injections of LBSA0103. The median duration of follow-up was 308 days. Adverse events (AEs), adverse drug reactions (ADRs), and serious AEs (SAEs) were monitored. Effectiveness was evaluated based on an index of effectiveness in accordance with the guidelines established by the Ministry of Food and Drug Safety and using a 100-mm visual analog scale (VAS) for weight-bearing pain. Overall, 250 subjects (7.96%) experienced 292 AEs and of these, unexpected AEs occurred in 114 subjects (3.63% [95% CI: 3.00-4.35]). Injection site pain was the most frequent AE reported by 81 subjects (2.58% [95% confidence intervals (CI): 2.05-3.20]). One hundred subjects experienced 108 ADRs (3.18% [95% CI: 2.60, 3.86]) and 15 unexpected ADRs were experienced by 13 subjects (0.41% [95% CI: 0.22-0.71]). Seventeen subjects experienced 22 SAEs (0.54% [95% CI: 0.32-0.87]) during the entire PMS period, and all were considered "unlikely" related to the study drug. Most AEs were mild in terms of severity and resolved during the study period. LBSA0103 was also effective in relieving symptomatic pain in knee OA patients. The condition in more than 80% of the subjects was considered to be improved when assessed by the investigators. LBSA0103 resulted in a significant reduction in the mean VAS score at 12 weeks after the first and second injections (24.79 (± 20.55) mm and 17.63 (±12.31) mm, respectively; p<0.0001). In conclusion, LBSA0103, used for the treatment of knee OA in a real-world setting, was well tolerated, with an acceptable safety profile and consistent therapeutic effect.


Assuntos
Ácido Hialurônico , Osteoartrite do Joelho , Humanos , Ácido Hialurônico/efeitos adversos , Injeções Intra-Articulares , Osteoartrite do Joelho/terapia , República da Coreia/epidemiologia , Dor/tratamento farmacológico , Dor/induzido quimicamente , Vigilância de Produtos Comercializados , Resultado do Tratamento
4.
Medicina (Kaunas) ; 58(11)2022 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-36363558

RESUMO

Root repair can prevent osteoarthritis (OA) by restoring hoop tension in medial meniscus posterior root tears (MMPRTs). This study aims to investigate bone marrow edema (BME) lesions known to be associated with OA following MMPRTs. Methods: Thirty patients with transtibial pull-out repair were recruited. Subchondral BME lesions were evaluated using magnetic resonance imaging (MRI) at 1-year follow-ups. Participants were categorized into three groups: no change of BME lesions (group one), improved BME lesions (group two) and worsened BME lesions (group three). Clinical scores and radiological outcomes, specifically Kellgren-Lawrence grade, medial joint space width and cartilage grade and meniscal extrusion were evaluated and compared between groups. Results: After surgery, twenty-three patients with no BME, three patients with BME lesions on the medial femoral condyle, one patient with BME lesions on the medial tibia plateau and three patients with BME lesions on both were investigated. A total of 20 patients in group one (66.7%) showed no change in BME lesions. In group two, seven patients (23.3%) presented with improved BME lesions. Only three patients (10%) showed worsened BME lesions (group three). Moreover, Lysholm scores and the rate of progression of cartilage grades were significantly worse in group three patients. Meniscal extrusion was significantly reduced in group two, whereas extrusion was significantly progressed in group three. Conclusion: Patients with worsened BME lesions showed less favorable outcomes than other patients. A decrease in meniscal extrusion can have a positive effect on BME lesions after root repair.


Assuntos
Doenças das Cartilagens , Osteoartrite , Lesões do Menisco Tibial , Humanos , Meniscos Tibiais/cirurgia , Lesões do Menisco Tibial/cirurgia , Lesões do Menisco Tibial/complicações , Medula Óssea , Estudos Retrospectivos , Imageamento por Ressonância Magnética , Edema
5.
Clin Orthop Surg ; 14(2): 220-226, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35685966

RESUMO

Background: Most epidemiologic studies of anterior cruciate ligament reconstruction (ACLR) to date have been conducted in Western populations, whereas no studies have been conducted in Asian populations. In this study, the incidence and trend of ACLR in Korea were investigated through an epidemiological big data analysis. Methods: The data were collected by the Health Insurance Review and Assessment Service from 2008 to 2016 in Korea. Patient records with the coding of cruciate ligament reconstruction were allocated, and ACLR patients were further refined by medical diagnosis coding. The total number and incidence of ACLR procedures per 100,000 person-years were investigated and more detailed analysis was conducted according to sex and age. Furthermore, concomitant surgical procedures performed during ACLR were investigated. Results: The total number and incidence of ACLR procedures rose from 10,248 and 21.8 to 14,500 and 29.1 between 2008 and 2016, respectively. The incidence of ACLR procedures increased by 33.5% over this 9-year period. Over this period, the total number and incidence increased from 8,543 and 36.4 to 11,534 and 46.4, respectively, in males and from 1,705 and 7.2 to 2,966 and 11.9, respectively, in females. ACLR was performed more frequently in males than in females; however, the increase rate was higher in females than males. ACLR was performed most frequently in patients in their 20s, followed by patients in their 30s, 40s, and 10s. The most frequent concomitant procedures performed during ACLR were meniscectomy (13.6% in 2008 and 9.8% in 2016) and meniscal repair (5.8% in 2008 and 8.8% in 2016). Conclusions: The incidence of ACLR consistently rose between 2008 and 2016 in Korea. The current study will enhance our understanding of the epidemiology of ACLR, which is needed to devise cost-effective preventive measures.


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Lesões do Menisco Tibial , Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/métodos , Estudos Epidemiológicos , Feminino , Humanos , Masculino , Meniscectomia , Lesões do Menisco Tibial/cirurgia
6.
Int J Sports Phys Ther ; 17(2): 193-200, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35136688

RESUMO

BACKGROUND: The Y-Balance test (YBT) is commonly used to evaluate balance after anterior cruciate ligament reconstruction (ACLR). However, several studies have also used it as a functional performance test (FPT). PURPOSE: This study aimed to examine the relationship between YBT scores and measures of knee joint laxity, static balance, knee flexor and extensor torque and strength ratio, and FPTs. STUDY DESIGN: Retrospective cohort study. METHODS: Fifty-nine patients who underwent ACLR using hamstring autografts were retrospectively analyzed. The Pearson correlation coefficient was used to determine the strength of the association between scores on the YBT and selected outcomes including laxity measured via the KT-2000 arthrometer, static balance measured via the Biodex Balance System, isokinetic muscle torque and hamstring-to-quadriceps (HQ) ratio, and performance on the single leg hop test and the single leg vertical jump test. RESULTS: Forty-six men and 13 women were included. The mean age and follow-up period were 29.6 ± 9.6 years and 12.4 ± 2.1 months, respectively. The KT-2000 arthrometer measures, Biodex Balance System scores, and HQ ratio measurements were not significantly correlated with the YBT scores. All YBT scores, except the YBT-anterior score, correlated with the isokinetic extensor and flexor torques (r-values: 0.271-0.520). All the YBT scores had significant weak to moderate correlations with the single leg hop test and single leg vertical jump test scores: YBT-anterior (r = 0.303, r = 0.258), YBT-posteromedial (r = 0.475, r = 0.412), YBT-posterolateral (r = 0.525, r = 0.377), and YBT-composite (r = 0.520, r = 0.412). CONCLUSION: Post-ACLR YBT scores correlated with functional performance and muscle strength, but not with static balance, joint laxity, and HQ ratios. The YBT scores as a measure of balance are related to improved functional performance and isokinetic torque measures. LEVEL OF EVIDENCE: 3.

7.
Medicine (Baltimore) ; 100(26): e26542, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34190191

RESUMO

BACKGROUND: GreenCross Wellbeing Corporation (GCWB) 106 is a food item based on Chrysanthemum zawadskii var. latilobum extract. It has an inhibitory effect on joint inflammation. OBJECTIVE: This study investigated the efficacy and safety of GCWB106 for osteoarthritis (OA) of the knee joint. METHODS: Overall, 121 participants with mild OA were recruited and randomly divided into two groups. One group received GCWB106 for 12 weeks and the other group received placebo for 12 weeks. Outcomes were evaluated using the Korean-Western Ontario and McMaster Universities Index (K-WOMAC), visual analog scale, Korean Short Form Health Survey 36 score, and laboratory test results. RESULTS: After 12 weeks of study treatment, the GCWB106 group exhibited a significant improvement compared with the placebo group in overall K-WOMAC score (P = .042) and K-WOMAC physical function score (P = .015). The GCWB106 group showed significant improvement in the visual analog scale pain score (P < .001) compared with the placebo group after 6 weeks and 12 weeks; no adverse drug reactions or serious adverse events were reported in either group. CONCLUSION: GCWB106 can safely reduce pain and improve knee function with therapeutic effects in OA of the knee joint. LEVEL OF EVIDENCE: Randomized, double-blind, placebo-controlled clinical study, Level I.


Assuntos
Artralgia , Chrysanthemum , Osteoartrite do Joelho , Extratos Vegetais , Qualidade de Vida , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/efeitos adversos , Artralgia/diagnóstico , Artralgia/tratamento farmacológico , Artralgia/etiologia , Método Duplo-Cego , Feminino , Estado Funcional , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico , Osteoartrite do Joelho/tratamento farmacológico , Osteoartrite do Joelho/fisiopatologia , Osteoartrite do Joelho/psicologia , Medição da Dor/métodos , Componentes Aéreos da Planta , Extratos Vegetais/administração & dosagem , Extratos Vegetais/efeitos adversos , Índice de Gravidade de Doença , Resultado do Tratamento
8.
Knee Surg Sports Traumatol Arthrosc ; 29(12): 4122-4130, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33730189

RESUMO

PURPOSE: No studies have been conducted to determine long-term predictors of clinical failure after surgical root repair. This study identified long-term prognostic factors of clinical failure after pull-out repair of medial meniscus posterior root tears (MMPRTs) at a minimum of 10 year follow-up. METHODS: A total of 37 patients who underwent MMPRT pull-out repair and had been observed for more than 10 years were recruited for this study. The mean follow-up period was 125.9 ± 21.2 months. Clinical failure of the procedures was defined as conversion to total knee arthroplasty (TKA). Participants were categorized into two groups: non-failure and failure groups. Various factors, including demographic features and radiologic findings, were analyzed and compared between the two groups. Meniscus extrusion was assessed at coronal magnetic resonance imaging preoperatively and 1 year postoperatively. Independent risk factors were determined by univariate analysis and logistic regression analysis. To determine the cut-off value for risk factors, the receiver-operating characteristic curve analysis was performed. RESULTS: In total, eight patients (22%) were converted to TKA during the follow-up period. With univariate analysis, statistically significant differences between two groups were observed in mechanical varus alignment (P = 0.018), rate of the number of patient with more meniscal extrusion values after surgery (P = 0.024), and the difference between the preoperative and 1-year postoperative value of meniscus extrusion (mm) (P = 0.010). In a logistic analysis, OR of mechanical varus alignment and differences in meniscus extrusion value before and 1 year after surgery was 1.5 (P = 0.048) and 3.7 (P = 0.034). The cut-off values of mechanical varus alignment and differences in meniscus extrusion values were 5 degrees and 0.7 mm. CONCLUSION: Clinically, preoperative varus alignment and increased meniscal extrusion after surgery were found to be predictive for a clinical failure after meniscal root repair in a long-term perspective. Thus, these negative prognostic factors should be taken into consideration for performing root repair in MMPRTs. LEVEL OF EVIDENCE: Level III.


Assuntos
Artroplastia do Joelho , Lesões do Menisco Tibial , Artroscopia , Humanos , Imageamento por Ressonância Magnética , Meniscos Tibiais/diagnóstico por imagem , Meniscos Tibiais/cirurgia , Estudos Retrospectivos , Lesões do Menisco Tibial/diagnóstico por imagem , Lesões do Menisco Tibial/cirurgia
9.
Knee Surg Sports Traumatol Arthrosc ; 29(12): 4131-4137, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33638685

RESUMO

PURPOSE: Meniscus allograft transplantation (MAT) can be performed to treat symptomatic patients with meniscus-deficient knees. However, the current epidemiologic status of MAT is unknown in many countries, including Korea. This study aimed to investigate the national trends of MAT in Korea which covers MAT procedures by the Korean national health insurance system. METHODS: Information from the national database was acquired through the Korean Health Insurance Review and Assessment Service (HIRA) from 2010 to 2017. All patients encoded as MAT were included. The total number of MATs and their incidence per 100,000 persons were determined, and the results were stratified by age and sex. RESULTS: The total number of MATs and their incidence per 100,000 persons per year were 369 and 0.77, respectively, in 2010, which increased to 826 and 1.72, respectively, in 2017. The number of MATs increased by 124% over 8 years. The peaks for the total number of MATs and their incidence were seen in patients in their 20 s in 2010, but in 2017, the peaks were observed in patients who were in their 40 s. MAT was performed more frequently in males (61%) than in females (39%) over the study period. CONCLUSION: The total number of MATs and their incidence had increased by 124% between 2010 and 2017. The peak treatment age range for MAT changed from 20 years of age in 2010 to 40 years of age in 2017, and MAT was performed more frequently in males than in females. LEVEL OF EVIDENCE: IV.


Assuntos
Meniscos Tibiais , Menisco , Adulto , Aloenxertos , Feminino , Humanos , Masculino , Meniscos Tibiais/cirurgia , República da Coreia/epidemiologia , Transplante Homólogo , Adulto Jovem
10.
Am J Sports Med ; 48(8): 1937-1944, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32437216

RESUMO

BACKGROUND: The importance of repair in medial meniscus posterior root tears (MMPRTs) has been increasingly recognized because it restores hoop tension. However, no study has compared the long-term outcomes between meniscectomy and repair. HYPOTHESIS: Survivorship and clinical outcomes of repair would be better than those of meniscectomy after long-term follow-up. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Between 2005 and 2009, patients with MMPRTs who had been followed up for at least 10 years after partial meniscectomy (n = 18) or pullout repair (n = 37) were recruited. Clinical assessments, including the Lysholm score and International Knee Documentation Committee (IKDC) subjective score, were evaluated preoperatively and at the final follow-up. The final results in each group were compared with the preoperative results, and the final results of the groups were compared. Clinical failure was defined as conversion to total knee arthroplasty (TKA), and the final clinical scores were assessed just before TKA. Kaplan-Meier survival analysis was used to investigate the survival rates of surgical procedures. RESULTS: Mean ± SD follow-up period was 101.4 ± 45.9 and 125.9 ± 21.2 months in the meniscectomy and repair groups, respectively (P = .140). The mean Lysholm and IKDC scores, respectively, in the meniscectomy group were 50.8 ± 7.7 and 37.6 ± 7.0 preoperatively and 58.2 ± 22.1 and 44.4 ± 19.0 postoperatively (P = .124; P = .240). In the repair group, the mean Lysholm score and IKDC score, respectively, significantly increased from 52.3 ± 10.9 and 41.0 ± 9.6 preoperatively to 77.1 ± 24.0 and 63.7 ± 20.6 postoperatively (P < .001; P < .001). The final Lysholm and IKDC scores in the repair group were significantly better than those in the meniscectomy group (P = .004; P = .003). In cases of clinical failure, 10 patients (56%) in the meniscectomy group and 8 patients (22%) in the repair group converted to TKA in the follow-up period (P = .016). According to Kaplan-Meier analysis, the 10-year survival rates for the meniscectomy and repair groups were 44.4% and 79.6%, respectively (P = .004). CONCLUSION: In MMPRTs, root repair was superior to partial meniscectomy in terms of clinical results for at least 10 years of follow-up. From a long-term perspective, repair with restoration of hoop tension is more effective management than meniscectomy.


Assuntos
Meniscectomia , Lesões do Menisco Tibial , Artroscopia , Seguimentos , Humanos , Meniscos Tibiais/cirurgia , Estudos Retrospectivos , Sobrevivência , Lesões do Menisco Tibial/cirurgia
11.
Arthroscopy ; 36(6): 1612-1624, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31785390

RESUMO

PURPOSE: The purpose of this study was to evaluate the clinical efficacy and safety of treating patients with a cartilage defect of the knee with microfractures and porcine-derived collagen-augmented chondrogenesis technique (C-ACT). METHODS: One hundred participants were randomly assigned to the control group (n = 48, microfracture) or the investigational group (n = 52, C-ACT). Clinical and magnetic resonance imaging (MRI) outcomes were assessed 12 and 24 months postoperatively for efficacy and adverse events. Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) assessment was used to analyze cartilage tissue repair. MRI outcomes for 50% defect filling and repaired tissue/reference cartilage (RT/RC) ratio were quantified using T2 mapping. Clinical outcomes were assessed using the visual analogue scale (VAS) for pain and 20% improvement, minimal clinically important difference (MCID), and patient acceptable symptom state for Knee Injury and Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee score. RESULTS: MOCART scores in the investigation group showed improved defect repair and filling (P = .0201), integration with the border zone (P = .0062), and effusion (P = .0079). MRI outcomes showed that the odds ratio (OR) for ≥50% defect filling at 12 months was statistically higher in the investigation group (OR 3.984, P = .0377). Moreover, the likelihood of the RT/RC OR becoming ≥1 was significantly higher (OR 11.37, P = .0126) in the investigation group. At 24 months postoperatively, the OR for the VAS 20% improvement rate was significantly higher in the investigational group (OR 2.808, P = .047). Twenty-three patients (52.3%) in the control group and 35 (77.8%) in the investigation group demonstrated more than the MCID of KOOS pain from baseline to 1 year postoperatively, with a significant difference between groups (P = .0116). CONCLUSION: In this multicenter randomized trial, the addition of C-ACT resulted in better filling of cartilage defect of the knee joint. LEVEL OF EVIDENCE: Level Ⅰ, Multicenter Randomized Controlled Trial.


Assuntos
Doenças das Cartilagens/terapia , Cartilagem Articular/transplante , Condrogênese/fisiologia , Colágeno/farmacologia , Fraturas de Estresse/terapia , Articulação do Joelho/cirurgia , Animais , Doenças das Cartilagens/complicações , Doenças das Cartilagens/diagnóstico , Feminino , Seguimentos , Fraturas de Estresse/etiologia , Fraturas de Estresse/patologia , Humanos , Articulação do Joelho/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Suínos , Transplante Autólogo , Resultado do Tratamento
12.
J Korean Med Sci ; 34(32): e206, 2019 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-31432650

RESUMO

BACKGROUND: Meniscus surgeries are frequently performed in orthopaedics. However, their current status is not well known in many countries, including Korea. This study aimed to investigate the national trends of meniscus surgery in Korea. METHODS: Information from the national database was acquired through the Korean Health Insurance Review and Assessment Service from 2010 to 2017. All cases coded as meniscectomy or meniscus repair were included. The total number and incidence of cases of meniscus surgery per 100,000 persons were determined, and the results were stratified by age and gender. The meniscus repair ratio for the total number of meniscus surgeries was evaluated. RESULTS: The total number and incidence of meniscectomy cases were 65,752 and 137, respectively, in 2010, which increased to 74,088 and 154, respectively, in 2017. The number of meniscectomies increased by 12.67% in 8 years. The total number and incidence of meniscus repair cases were 9,055 and 18, respectively, in 2010, which increased to 14,947 and 31 in 2017. The number of meniscus repairs increased by 65.04%. The meniscus repair ratio was 12.1% in 2010, which increased to 16.8% in 2017. The highest peak was noted for patients who underwent meniscus surgeries in their 50s and 60s. Meniscectomy was performed more frequently in women (57%) than in men (43%), whereas repair was performed more frequently in men (54%) than in women (46%) over the study period. CONCLUSION: The total number and incidence of meniscus surgeries increased from 2010 to 2017; the number and incidence of meniscus repair procedures increased more rapidly than those of meniscectomy, with the peak treatment age for both surgeries being in the 50s and 60s. The current study will contribute to understanding the epidemiology of meniscus surgery, its prevention, and cost-saving measures in Korea.


Assuntos
Meniscectomia/tendências , Menisco/cirurgia , Lesões do Menisco Tibial/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Feminino , Humanos , Incidência , Masculino , Meniscectomia/estatística & dados numéricos , Meniscos Tibiais/cirurgia , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Estudos Retrospectivos , Lesões do Menisco Tibial/epidemiologia
13.
Clin Orthop Surg ; 11(2): 164-169, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31156767

RESUMO

BACKGROUND: To translate into Korean and culturally adapt the anterior cruciate ligament-return to sports after injury (ACL-RSI) scale assessing psychological readiness to return to sports after ACL reconstruction and to validate its psychometric properties. METHODS: The ACL-RSI scale was forward translated into Korean and back-translated into English for cultural adaptation according to the standardized guideline. For validation, the Korean version of the ACL-RSI (ACL-RSI Kr) was administered to patients who underwent ACL reconstruction. The following subjective questionnaires were also administered: International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC-SKF), Lysholm scale, Knee injury and Osteoarthritis Outcome Score (KOOS), and a Return to Sports Questionnaire. Test-retest reliability, internal consistency, content validity, construct validity, and discriminant validity of the ACL-RSI Kr were assessed. RESULTS: A total of 129 patients (102 men and 27 women) were included in the study. Their mean age was 28.3 years. The average follow-up duration was 13.2 months. Test-retest reliability was remarkable (intraclass correlation coefficient, 0.949), internal consistency was high (Cronbach's alpha, 0.932), and floor and ceiling effects were confirmed to be less than 10%. Construct validity assessed by correlation analysis with KOOS, IKDC-SKF, and Lysholm scale showed the correlation coefficients ranging from 0.169 to 0.679 (all p < 0.01). Compared with the Return to Sports Questionnaire, statistically significant difference was found in the ACL-RSI Kr between patients who received more than 7 points and less than 7 points (72.2 vs. 60.3, p = 0.025) for performance level scored using a 10-point Likert scale, proving its discriminative value. CONCLUSIONS: The ACL-RSI Kr demonstrated good psychometric properties. This scale can be an excellent instrument for evaluating patient's psychological readiness to return to sports after ACL injury.


Assuntos
Reconstrução do Ligamento Cruzado Anterior , Comparação Transcultural , Psicometria/métodos , Volta ao Esporte/psicologia , Adulto , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , República da Coreia , Traduções
14.
Indian J Orthop ; 53(3): 431-436, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31080283

RESUMO

BACKGROUND: This study aimed to identify the factors associated with patient satisfaction with the outcome of meniscal allograft transplantation (MAT). MATERIALS AND METHODS: Patients treated with MAT from March 2006 to May 2009 were asked to complete a five-point Likert scale regarding satisfaction with the outcome of MAT, in addition to the following subjective outcome evaluation forms: the International Knee Documentation Committee (IKDC) subjective forms, Knee Society Score knee and function forms, and Lysholm Knee Scoring Scale. We collected radiologic data using X-ray and magnetic resonance imaging and assessed isokinetic muscle strength test using the Biodex System 3. We investigated whether these parameters were significantly associated with patient satisfaction. Statistical analysis was computed using univariate and multivariable logistic regression. RESULTS: Among the 130 patients who underwent MAT, 49 participated in the interview and were included in this study. The mean followup period was 50.4 months. Mean patient age was 40 (±9) years; 33 were male and 16 were female (33%). The lateral meniscus was transplanted in 13 (27%) patients, while the medial meniscus was involved in 36 (73%) patients. On univariate analysis, sex and isokinetic extension strength deficit at 60° and 180° as well as the IKDC, Knee Society, and Lysholm scores showed significant association with patient satisfaction regarding the outcome. On multivariable logistic regression, only the IKDC score showed a significant association, with P = 0.04. CONCLUSIONS: The study results support the importance of patient-reported subjective outcomes in terms of patient satisfaction following a surgical procedure. Regarding MAT, the IKDC outcome score reflects patient satisfaction. LEVEL OF EVIDENCE: Level III.

16.
Knee Surg Sports Traumatol Arthrosc ; 27(1): 189-196, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30006654

RESUMO

PURPOSE: This study investigated the outcomes of pullout fixation for medial meniscus posterior root tears (MMPRTs) in patients ≤ 60 years old versus patients > 60 years old. It was hypothesized that older patients would demonstrate results comparable with those of younger patients. METHODS: Patients with pullout fixation who were followed-up for more than 5 years were included. Patients were categorized into two groups based on age (group A, ≤ 60 years; group B, > 60 years). The Lysholm score, Kellgren-Lawrence (K-L, 0/1/2/3/4) grade, and medial joint space width were evaluated retrospectively. Preoperative results were compared with the final results in each group, which were compared between groups. RESULTS: Twenty-five patients in group A (mean age, 54.7 ± 3.8 years) and 22 patients in group B (mean age, 65.6 ± 4.4 years) were recruited. The mean follow-up duration was 70.9 months. The Lysholm score (group A, 53.0 ± 9.1 to 86.0 ± 12.1, P < 0.001; group B, 51.1 ± 7.1 to 82.9 ± 9.7, P < 0.001) improved significantly. However, the joint space width (group A, 4.7 ± 1.1 to 3.9 ± 1.1 mm, P < 0.001; group B, 4.7 ± 0.9 to 3.8 ± 0.9 mm, P < 0.001) and K-L grade (group A, 3/17/5/0/0 to 0/7/11/7/0, P < 0.001; group B, 2/14/6/0/0 to 0/3/14/5/0, P < 0.001) worsened significantly. No significant differences between groups were observed in final outcomes, including Lysholm score (n.s.), K-L grade (n.s.), and joint space narrowing (n.s.). No case with operation failure that require total knee arthroplasty was not observed. CONCLUSION: MMPRT fixation did not prevent the progression of arthrosis completely. However, clinical outcomes were not age-dependent. Thus, age may not be a critical factor to consider when applying fixation. LEVEL OF EVIDENCE: Retrospective case-control study; Level of evidence, IV.


Assuntos
Progressão da Doença , Osteoartrite do Joelho/fisiopatologia , Lesões do Menisco Tibial/fisiopatologia , Lesões do Menisco Tibial/cirurgia , Fatores Etários , Idoso , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Escore de Lysholm para Joelho , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/prevenção & controle , Estudos Retrospectivos
17.
World J Mens Health ; 36(2): 147-152, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29623694

RESUMO

PURPOSE: We investigated the correlations of serum total testosterone (TT) levels with body composition and physical fitness parameters in patients with erectile dysfunction (ED) to know the best exercise for testosterone deficiency. MATERIALS AND METHODS: Eighty-seven ED patients underwent serum TT assessment as well as body composition and basic exercise testing. The bioelectrical impedance analysis was used to assess body composition. Seven types of basic exercise tests were used to determine physical fitness. Correlations between serum TT levels and body composition/physical function parameters were evaluated using partial correlation analyses. A serum TT cut-off value was obtained for the parameters significantly correlated with serum TT levels. RESULTS: The subjects had a mean serum TT level of 342.1 ng/dL. Among the body composition parameters, body and abdominal fat percentages showed statistically significant negative correlations with serum TT levels. Among the basic exercise test parameters, only the cycle ergometer test for cardiorespiratory fitness showed a statistically significant positive correlation with serum TT levels. CONCLUSIONS: Serum TT levels in patients with ED, may be increased by reducing fat percentage and improving cardiorespiratory fitness via aerobic exercise.

18.
Hum Gene Ther Clin Dev ; 29(1): 48-59, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29641281

RESUMO

The aim of this study was to test the clinical efficacy of TissueGene-C (TG-C), a cell and gene therapeutic for osteoarthritis consisting of non-transformed and transduced chondrocytes (3:1) retrovirally transduced to overexpress transforming growth factor-ß1. A total of 163 Kellgren-Lawrence grade 3 patients with knee osteoarthritis were randomly assigned to receive intra-articular TG-C or placebo. Primary efficacy measures included criteria for subjective assessment by International Knee Documentation Committee (IKDC) and pain severity by Visual Analog Scale (VAS) for 52 weeks. Secondary efficacy measures included IKDC and VAS at 26 and 39 weeks; pain, stiffness, and physical function by the Western Ontario and McMaster Universities Arthritis Index (WOMAC); and pain, symptoms, daily activities, function in sports and recreation, and quality of life by the Knee Injury and Osteoarthritis Outcome Score (KOOS), X-ray, magnetic resonance imaging, and soluble urine and blood biomarkers. TG-C was associated with statistically significant improvement over placebo in the total IKDC score and individual categories, and in the VAS score at 26, 39, and 52 weeks. WOMAC and KOOS scores also improved with TG-C over placebo. Patients treated with TG-C showed trends directed toward thicker cartilage and slower growing rates of subchondral bone surface area in the medial tibia, lateral tibia, lateral patella, and lateral patella femoral regions, although these were not statistically significant (p > 0.05). Serum C-terminal telopeptide of type I collagen (CTX-I) and urine CTX-II levels were lower over 1 year in TG-C than placebo-treated patients, with CTX-I level reaching statistical significance. These tendencies supported TG-C as holding great potential as a disease-modifying osteoarthritis drug. The most frequent adverse events in the TG-C group were peripheral edema (9%), arthralgia (8%), joint swelling (6%), and injection site pain (5%). TG-C was associated with statistically significant improvements in function and pain in patients with knee osteoarthritis. The unexpected adverse events were not observed.


Assuntos
Terapia Genética/efeitos adversos , Osteoartrite do Joelho/terapia , Idoso , Cartilagem/metabolismo , Cartilagem/fisiologia , Colágeno Tipo I/sangue , Colágeno Tipo I/genética , Colágeno Tipo I/metabolismo , Colágeno Tipo I/urina , Método Duplo-Cego , Feminino , Terapia Genética/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Regeneração
19.
Arthroscopy ; 34(4): 1060-1068, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29366743

RESUMO

PURPOSE: To compare tibiofemoral contact mechanics after fixation for medial meniscus posterior root radial tears (MMPRTs). METHODS: Seven fresh knees from mature pigs were used. Each knee was tested under 5 conditions: normal knee, MMPRT, pullout fixation with simple sutures, fixation with modified Mason-Allen sutures, and all-inside fixation using Fastfix 360. The peak contact pressure and contact surface area were evaluated using a capacitive sensor positioned between the meniscus and tibial plateau, under a 1,000-N compression force, at different flexion angles (0°, 30°, 60°, and 90°). RESULTS: The peak contact pressure was significantly higher in MMPRTs than in normal knees (P = .018). Although the peak contact pressure decreased significantly after fixation at all flexion angles (P = .031), it never recovered to the values noted in the normal meniscus. No difference was observed among fixation groups (P = .054). The contact surface area was significantly lower in MMPRTs than in the normal meniscus (P = .018) and increased significantly after fixation at all flexion angles (P = .018) but did not recover to within normal limits. For all flexion angles except 60°, the contact surface area was significantly higher for fixation with Mason-Allen sutures than for fixation with simple sutures or all-inside fixation (P = .027). At 90° of flexion, the contact surface area was significantly better for fixation with simple sutures than for all-inside fixation (P = .031). CONCLUSIONS: The peak contact pressure and contact surface area improved significantly after fixation, regardless of the fixation method, but did not recover to the levels noted in the normal meniscus after any type of fixation. Among the fixation methods evaluated in this time 0 study, fixation using modified Mason-Allen sutures provided a superior contact surface area compared with that noted after fixation using simple sutures or all-inside fixation, except at 60° of flexion. However, this study had insufficient power to accurately detect the differences between the outcomes of various fixation methods. CLINICAL RELEVANCE: Our results in a porcine model suggest that fixation can restore tibiofemoral contact mechanics in MMPRT and that fixation with a locking mechanism leads to superior biomechanical properties.


Assuntos
Meniscos Tibiais/cirurgia , Lesões do Menisco Tibial/cirurgia , Animais , Fenômenos Biomecânicos , Fêmur/fisiopatologia , Traumatismos do Joelho/cirurgia , Articulação do Joelho/fisiopatologia , Articulação do Joelho/cirurgia , Meniscos Tibiais/fisiopatologia , Procedimentos Ortopédicos/métodos , Período Pós-Operatório , Pressão , Amplitude de Movimento Articular , Sus scrofa , Técnicas de Sutura , Suturas , Tíbia/fisiopatologia
20.
Arthroscopy ; 34(2): 530-535, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29183645

RESUMO

PURPOSE: This study investigated the clinical outcomes and mid- to long-term survival rates in patients undergoing transtibial pullout repair of medial meniscus posterior root tears (MMPRTs) after a minimum follow-up of 5 years. METHODS: Between 2005 and 2011, patients with MMPRTs who had been followed for at least 5 years after undergoing transtibial pullout repair were recruited. Participants were identified using medical records and information in a prospectively collected database. Clinical outcomes were assessed based on a comparison of patient preoperative Lysholm scores and their scores at the final follow-up. A Kaplan-Meier survival analysis was used to investigate the survival rates of repair procedures. Clinical failures were defined as cases requiring conversion to total knee arthroplasty (TKA) or having final Lysholm score <65 or less than their preoperative scores. RESULTS: Overall, 91 patients (mean age, 58.7 ± 9.7 years) were included: the mean follow-up duration was 84.8 ± 13.8 months. Among these patients, the mean Lysholm score improved significantly from 51.8 ± 7.9 preoperatively to 83.0 ± 11.1 at the final follow-up (P < .001). Overall, 4 patients failed due to conversion to TKA (n = 1) or having final Lysholm scores <65 or less than the preoperative scores (n = 3). The overall Kaplan-Meier probabilities of survival after repair were 99% at 5 years, 98% at 6 years, 95% at 7 years, and 92% at 8 years. CONCLUSIONS: Among patients with MMPRTs, transtibial pullout repair demonstrated a high clinical survival rate and the patients demonstrated clinical improvement, based on mid- and long-term follow-up examinations. LEVEL OF EVIDENCE: Level IV, retrospective uncontrolled case series.


Assuntos
Artroscopia/métodos , Previsões , Meniscos Tibiais/cirurgia , Sobrevivência , Lesões do Menisco Tibial/cirurgia , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Imageamento por Ressonância Magnética , Masculino , Meniscos Tibiais/diagnóstico por imagem , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Lesões do Menisco Tibial/diagnóstico , Lesões do Menisco Tibial/mortalidade
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