Although the frequency of arthroscopic revision surgery is increasing in patients with recurrent dislocation after a primary shoulder stabilization, the literature describing arthroscopic revision Bankart repair has been limited. Preferred reporting items for systematic meta-analyses guidelines were followed by utilizing PubMed, EMBASE, Scopus, and Cochrane Library databases. Keywords included shoulder dislocation, anterior shoulder instability, revision surgery, stabilization, and arthroscopic Bankart repair. Quality assessments were performed with criteria from the methodological index for nonrandomized studies (MINORS). A total of 14 articles were included in this analysis. The mean MINORS score was 12.43. A total of 339 shoulders (337 patients) were included (281 males and 56 females). The mean follow-up period was 36.7 months. Primary surgeries were as follows: arthroscopic procedures (n = 172, 50.7%), open procedure (n = 87, 25.7%), and unknown (n = 80, 23.6%). The mean rate of recurrent instability after revision arthroscopic Bankart repair was 15.3% (n = 52), and an additional re-revision procedure was needed in 6.5% of cases (n = 22). Overall, there were 18.0% (n = 61) of complications reported. This systematic review suggests that arthroscopic revision Bankart repair can lead to an improvement in functional outcomes and reasonable patient satisfaction with proper patient selection.

This study evaluated the correction rates of idiopathic genu valgum or varum after percutaneous epiphysiodesis using transphyseal screws (PETS) and analyzed the affecting factors. A total of 35 children without underlying diseases were enrolled containing 64 physes (44 distal femoral (DT), 20 proximal tibial (PT)). Anatomic tibiofemoral angle (aTFA) and the mechanical axis deviation (MAD) were taken from teleroentgenograms before PETS surgery and screw removal. The correction rates of the valgus and varus deformities for patients treated with PETS were 1.146°/month and 0.639°/month using aTFA while using MAD showed rates of 4.884%/month and 3.094%/month. After aTFA (p < 0.001) and MAD (p < 0.001) analyses, the correction rate of DF was significantly faster than that of PT. Under multivariable analysis, the aTFA correction rate was significantly faster in younger patients (p < 0.001), in males (p < 0.001), in patients with lower weights (p < 0.001), and in the group that was screwed at DF (p < 0.001). Meanwhile, the MAD correction rate was significantly faster in patients with lower heights (p = 0.003). PETS is an effective treatment method for valgus and varus deformities in growing children and clinical characters should be considered to estimate the correction rate.

Background and objectives: The differences between computed radiography-based teleoroentgenograms (CR-based teleoroentgenograms) and an EOS® imaging system were evaluated by measuring lower extremity lengths and alignments. Materials and methods: The leg length [L], femur length [F], tibia length [T], and hip–knee–ankle (HKA) angle were measured in 101 patients with lower extremity disease by a CR-based teleoroentgenogram with computed radiography and an EOS®. The additive length of the femoral and tibial segments (F + T) was determined by adding the two length values. Then, the differences among all five parameters between the two techniques were analyzed. The magnification (mm) was calculated by subtracting the length measurements on the EOS® from those in the scanogram. Furthermore, the magnification percentage (%) was calculated by dividing the magnification with the measurements on the EOS®. Results: The magnification errors (mean ± standard deviation), when comparing both right and left sides, were 7.80 ± 1.41%, 7.3 ± 6.01%, 5.16 ± 1.25%, and 6.45 ± 0.94% for L, F, T, and F + T, respectively. For limb length, the CR-based teleoroentgenogram had an average magnification of 6.8% (range, 5.2 to 7.8%) compared to the EOS® imaging. The two groups displayed a statistical difference (p < 0.01), except for the HKA angle. Conclusions: The CR-based teleoroentgenogram had a magnification of about 6.8% compared to the EOS® imaging system in evaluating lower extremity length. Therefore, more attention must be given to CR-based teleoroentgenograms to correct angular deformities.

Background: Despite genu varum's status as a common pediatric problem, there remain no serial studies investigating the natural course of excessive physiologic genu varum in children. This study, therefore, aims to identify the natural course of the anatomical tibiofemoral angle (aTFA) in children with excessive physiologic genu varum without any underlying pathological conditions. Materials and methods:Between 1997 and 2008, among 70 children who had been referred from a primary hospital to evaluate angular deformity of the knee, 29 consecutive limbs (10 bilateral and 9 unilateral) of 19 healthy Korean children with excessive physiologic genu varum equal to or greater than 2 standard deviations (SDs) of the aTFA at their initial visit until all children were 6 years of age. We analyzed the value of the aTFA as well as the changes in patterns, and compared our findings with results from previous studies. Results:The mean aTFA at the initial visit was 18° varus (range: 9° to 36°), the mean age of normalization was 3.2 years, and the mean value of the aTFA was varus 17.2° at the age of 1 year, followed by a steady decrease to 0° at almost the age of 3.3 years. Starting at the age of 4 years, the aTFA was a mean of 5.2° genu valgum and gradually changed until the age of 6 years, where it was sustained at an average of 3.4° genu valgum. Conclusion:Excessive physiological genu varum exceeding 2 SD in young Korean children improved spontaneously without the need for prosthetics or orthotics.

PurposeTotal knee arthroplasty (TKA) is often performed sequentially on both sides during a single hospital stay. Patients who experience postoperative nausea and vomiting (PONV) after the first operation are concerned about PONV recurrence after the second operation. However, there are few studies regarding the incidence of PONV in staged bilateral TKA with a ≥ 1‐week interval. This study aimed to identify the differences in (1) PONV incidence, (2) use of rescue antiemetics, and (3) the amount of opioid consumption between the first and second operations for staged bilateral TKA with a 1‐week interval. Based on our anecdotal experience, the hypothesis of this study was that during staged bilateral TKA at a 1‐week interval, the PONV incidence and rescue antiemetic requirement after the second operation will be lower than those after the first operation, regardless of opioid consumption. MethodsFifty‐eight consecutive patients who underwent staged bilateral TKA with a 1‐week interval were retrospectively reviewed. All second‐stage operations were performed with the same anaesthesia protocol and perioperative patient management protocol as the first‐stage operation. PONV incidence was the primary outcome. The requirement for rescue antiemetic drugs and the amount of opioid consumption were secondary outcome variables. The outcome variables were recorded during three postoperative days (Days 0–2) for each stage and were compared between the first and second operations. ResultsThe incidence rates of nausea and vomiting on Day 0 (p = 0.001 and p = 0.004, respectively) and nausea on Day 1 (p = 0.008) were significantly lower after the second operation. Rescue antiemetic use on Day 0 was significantly lower after the second operation (p = 0.001). The total opioid consumption 72 h after surgery was significantly higher after the second operation (61.76 vs. 34.28 mg, p < 0.001). ConclusionDuring staged bilateral TKA with a 1‐week interval, PONV incidence was lower after the second operation, even with increased opioid consumption. Level of evidenceIII.