Purpose Microfracture is an established method to treat osteochondral defects of the talus. The value of the addition of an acellular matrix is still under debate. This study compared the results of arthroscopic microfracture vs. arthroscopic autologous matrix‐induced chondrogenesis using a collagen I/III matrix (AMIC) in the management of articular cartilage defects of the talus. Methods Patients with a minimum follow‐up of 5 years after arthroscopic management for an articular cartilage defect of the talus with either microfracture alone or an additional acellular matrix were matched according to age, sex and BMI. The Hannover Scoring System for the ankle (HSS) and a Visual analog scale (VAS) for pain, function and satisfaction were used to evaluate the clinical outcome. Postoperative MRI was used to assess cartilage repair tissue based on the degree of defect repair and filling of the defect, integration to border zone, surface of the repair tissue, structure of the repair tissue, and subchondral bone alterations. Results Thirty‐two patients (16 microfracture, 16 AMIC) were included. No significant between‐group differences were observed in demographic data and preoperative score values. Both groups showed statistically significant improvement when comparing the pre‐ and postoperative score values. No statistically significant differences were identified between the median values of the groups with the HSS (microfracture: 82 (range 71–96) points; AMIC 88 (range 40–98) points). Accordingly, no significant differences were observed for the VAS pain (microfracture: 0.95 (range 0–3.8); AMIC: 1.0 (range 0–8.5)), VAS function (microfracture: 8.4 (range 3.5–10); AMIC: 9.0 (range 1.5–10)) and VAS satisfaction (microfracture: 8.9 (range 2.8–10); AMIC: 9.45 (range 1.5–10)). MRI showed regeneration of tissue in the treated area without differences between the two groups. Conclusion Good clinical results were observed for arthroscopic microfracture with or without an additional acellular collagen I/III matrix in the treatment for articular cartilage defects of the talus. It appears that for defects as treated in this study, it is not worthwhile adding the collagen I/III matrix to the microfractures. Level of evidence III.

Both in vitro and in vivo experiments have confirmed that platelet-rich plasma has therapeutic effects on many neuropathies, but its effects on carpal tunnel syndrome remain poorly understood. We aimed to investigate whether single injection of platelet-rich plasma can improve the clinical symptoms of carpal tunnel syndrome. Fourteen patients presenting with median nerve injury who had suffered from mild carpal tunnel syndrome for over 3 months were included in this study. Under ultrasound guidance, 1–2 mL of platelet-rich plasma was injected into the region around the median nerve at the proximal edge of the carpal tunnel. At 1 month after single injection of platelet-rich plasma, Visual Analogue Scale results showed that pain almost disappeared in eight patients and it was obviously alleviated in three patients. Simultaneously, the disabilities of the arm, shoulder and hand questionnaire showed that upper limb function was obviously improved. In addition, no ultrasonographic manifestation of the carpal tunnel syndrome was found in five patients during ultrasonographic measurement of the width of the median nerve. During 3-month follow-up, the pain was not greatly alleviated in three patients. These findings show very encouraging mid-term outcomes regarding use of platelet-rich plasma for the treatment of carpal tunnel syndrome.

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Given the growing rate of revision total knee arthroplasties (TKAs), it is important to understand the potential risk factors associated with postoperative complications. The aim of this study was to determine the role of operative time in postoperative complications in revision TKA. A retrospective cohort study was performed using data from the American College of Surgeons National Surgical Quality Improvement Program database. Patients who had undergone revision TKA between 2007 and 2016 were identified and analyzed based on operative time. The effect of operative time on postoperative complications was examined using multinomial multivariate analysis. A total of 14,769 revision TKA patients were included. On adjusted multivariate analysis, each additional 15 minutes of operative time increased the likelihood of wound complications (odds ratio, 1.023; P =.020), postoperative blood transfusion (odds ratio, 1.169; P <.001), and extended hospital stay (odds ratio, 1.060; P <.001). An increase of 15 minutes of operative time was associated with several postoperative complications. Although operative time is often an uncontrollable factor, surgeons should consider the effect of prolonged operative time on potential complications in the acute postoperative period. [ Orthopedics . 2021;44(1):18–22.]