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Special Issue Editors

Dr. Joaquín Moya-Angeler

E-Mail Website
Guest Editor

1. Department of Orthopaedic Surgery and Traumatology, Hospital General Universitario Reina Sofía, 30003 Murcia, Spain
2. Instituto de Cirugía Avanzada de la Rodilla (ICAR), 30005 Murcia, Spain
Interests: knee preservation; knee replacement; osteotomies; sports medicines; ACL reconstruction; patellofemoral disorders; trochlear dysplasia; meniscus

Prof. Dr. Francisco Forriol

E-Mail Website
Guest Editor

School of Medicine, Universidad San Pablo CEU, Ctra. Boadilla del Monte, Km. 5 300, 28925 Alcorcon, Madrid, Spain
Interests: knee surgery; orthopedic surgery; muscle; bone; limb salvage

Special Issue Information

Dear Colleagues,

We find ourselves standing at a pivotal moment in the realm of knee arthroplasty surgery. For nearly half a century, the landscape of this surgical field has seen limited transformations. However, in recent times, we have witnessed a surge of innovations propelled by the development of more advanced techniques and implants. Our early endeavors revolved around mitigating severe complications and ensuring the durability of implants through the refinement of bearing surfaces, enhanced biological fixations, precise instrumentation systems, and less invasive approaches. Yet, it is equally evident that the once universally accepted principles now demand a more evidence-based evaluation.

This profound transformation currently underway focuses on the integration of personalized medicine principles into knee arthroplasty. Clinicians and researchers now champion diverse philosophies of component alignment and knee prosthesis biomechanics. These philosophies acknowledge the uniqueness of each joint, advocating for a tailored approach to suit individual patients. Our ultimate goal is to enhance arthroplasty longevity and functionality, elevate each patient's health-related quality of life, and achieve a sense of normalcy in the operated knee. We aim for our patients to forget they underwent surgery.

With these changes, we have witnessed an abundance of data and insights. This Special Issue endeavors to serve as an inclusive platform for disseminating these innovative contributions and expanding our knowledge.

Topics to be explored include:

New concepts in alignment;
The integration of technology in knee arthroplasty;
Advancements in customized surgery;
Exploring extended reality and immersive technologies;
Defining the limits and unveiling future challenges.

We invite you all to be part of this transformative journey. Together, let us delve into the forefront of knee arthroplasty, redefining the landscape of this discipline and improving the lives of our patients.

Dr. Joaquín Moya-Angeler
Prof. Dr. Francisco Forriol
Guest Editors

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

knee
knee replacement
knee arthroplasty
knee alignment techniques
robotic knee arthroplasty

Published Papers (2 papers)

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Research

Jump to: Review

10 pages, 266 KiB

Open AccessArticle

Evaluating the Minimum Clinically Important Difference and Patient Acceptable Symptom State for the Womac Osteoarthritis Index after Unicompartmental Knee Arthroplasty

by Umile Giuseppe Longo, Rocco Papalia, Stefano Campi, Sergio De Salvatore, Ilaria Piergentili, Benedetta Bandini, Alberto Lalli and Vincenzo Denaro

J. Clin. Med. 2023, 12(24), 7618; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12247618 - 11 Dec 2023

Viewed by 920

Abstract

Patient-Reported Outcome Measures (PROMs) are standardized questionnaires that gather information on health-related quality of life directly from patients. Since a significant statistical mean change may not correspond to a clinical improvement, there is a need to calculate a considerable change in scores. This is done by the Minimum Clinically Important Difference (MCID) and Patient Acceptable Symptom State (PASS). The objective of this article is to report the MCID and the PASS values of the WOMAC (Western Ontario and McMaster University) osteoarthritis index for patients undergoing Unicompartmental Knee Arthroplasty (UKA). A total of 37 patients (25 females and 12 males; mean age 68 ± 8.1 years and mean BMI 28.7 ± 4) who underwent UKA were enrolled. All patients were assessed using the WOMAC and the Oxford Knee Score (OKS) questionnaires before and six months following the procedure. To measure the cut-off values for MCID, distribution methods and anchor methods were applied, while the PASS was assessed only via anchor approaches. The MCID related to the WOMAC average global score was 90.7 ± 7.6, the average pain dimension score was 93.2 ± 6.6, the average stiffness dimension score was 92.6 ± 17, and the average physical function dimension score was 89.7 ± 7.6. In terms of PASS, the normalized WOMAC was 82.8, the pain dimension was 87.5, the stiffness dimension was 93.7, and the functional dimension was 83.1. A 34.5 amelioration in the WOMAC score, from initial evaluation to final follow-up, using change in OKS > 5 as anchor, indicates that the patients’ health state improved to a clinically significant degree. A value at least of 82.8 in WOMAC score after treatment denotes that the symptom state is deemed acceptable by most of the patients. Full article

(This article belongs to the Special Issue Knee Arthroplasty Surgery: Management and Future Opportunities)

Review

Jump to: Research

11 pages, 402 KiB

Open AccessReview

Why Kinematic Alignment Makes Little Sense in Valgus Osteoarthritis of the Knee: A Narrative Review

by Christian Manuel Sterneder, Martin Faschingbauer, Lyubomir Haralambiev, Maximilian F. Kasparek and Friedrich Boettner

J. Clin. Med. 2024, 13(5), 1302; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm13051302 - 25 Feb 2024

Viewed by 546

Abstract

There is a debate about the best alignment strategies in total knee arthroplasty (TKA). Mechanical alignment (MA) targets in combination with necessary soft tissue releases are the gold standard for TKA in end-stage valgus osteoarthritis. Some authors propagate kinematic alignment (KA) with the aim of restoring the patient’s native alignment and minimizing the need for soft tissue releases. Our previous studies showed that MA with standardized soft tissue release produces reproducible results, and that the preoperative phenotype does not influence the results of patients with valgus osteoarthritis. These data suggest that there is no functional advantage to preserving valgus alignment in patients with valgus osteoarthritis. Many patients with valgus osteoarthritis present with a compromised medial collateral ligament and leaving the knee in valgus could increase the risk of secondary instability. The current literature supports MA TKA with soft tissue release as the gold standard. While using more sophisticated enabling technologies like robotic surgery might allow for aiming for very slight (1–2°) valgus alignment on the femoral side, any valgus alignment outside this range should be avoided. This review paper summarizes our current knowledge on the surgical techniques of TKA in patients with valgus osteoarthritis. Full article

(This article belongs to the Special Issue Knee Arthroplasty Surgery: Management and Future Opportunities)

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