Introduction. Injuries of the ACL are the most common ligamentous injuries of the knee joint, highlighting the importance of tools to easily determine the patients from a risk group. Aims. The aims of this study were: to establish whether the posterior condylar angle (PCA) is a risk factor of ACL injury among 18-30 year-old males and to assess the differences in PCA among patients with isolated ACL injury vs. ACL injury combined with acute MCL, or meniscal injury. Methods and materials. A case group was formed, according to a priori power analysis (α = 0.05, β = 0.95), with 44 patients with an ACL injury and a control group with 44 healthy patients. Then, the case group was subdivided into three subgroups: the MCL and meniscal injured. Two lines were drawn on the axial MRI – the posterior condylar axis and the surgical transepicondylar axis. The PCA was defined as the angle between them. Statistical analyses included U Mann-Whitney, t-student independent-sample tests, linear regression models and correlation analyses. Results. The mean PCA in the control and study group was 1.90° ±1.25° and 1.30° ±2.49°(p = 0.178), respectively. Univariate analyses of PCA in isolated ACL injury vs. ACL injury combined with acute MCL, MM or LM injury had p values of 0.981, 0.814 and 0.813, respectively. Multivariable analysis had p values of 0.744, 0.421 and 0.873, respectively. Intrarater ICCs were 0.931 and 0.928 (excellent reliability) and interrater ICCs was 0.868 (good reliability). Conclusions. PCA is not associated with acute ACL injuries in the studied population. MCL or meniscal injuries did not alter PCA values among patients with an ACL injury.

Arthritis is the most common joint disease. It impairs patients quality of life on account of the associated chronic pain and loss of joint function. The thumb is the most important digit of the hand and trapeziometacarpal osteoarthritis (carpometacarpal arthritis / CMC-1 arthritis) may significantly compromise functions of the entire hand. CMC-1 arthritis produces several non-specific symptoms, affecting mainly postmenopausal women. The risk of developing CMC-1 arthritis increases with age.Considering these facts, knowledge about the etiopathogenesis and diagnosis of CMC-1 arthritis should be widely disseminated and based on evidence-based medicine. The first step in the diagnostic work-up is a detailed history and clinical examination where the use of more sensitive tests than the grind test, e.g. the pressure-shear test, is recommended. It is advisable to widen the classic radiographic views with additional thumb projections such as Roberts view. The use of magnetic resonance imaging or computed tomography is only advised in special individual cases.This paper aims to present the most up-to-date knowledge about: (1) the anatomy and biomechanics of the trapeziometacarpal joint, (2) the epidemiology of CMC-1 arthritis and (3) its diagnosis. It is based on the latest literature (mainly works published in the last 5 years) acquired from databases such as PubMed, Clinical Key and Science Direct. The article is the first of a two-part series that presents a diagnostic-therapeutic algorithm for CMC-1 arthritis. The authors believe that it may contribute to broadening knowledge about CMC-1 arthritis, optimizing the therapeutic process and improving care for patients with CMC-1 arthritis in Poland.

Trapeziometacarpal osteoarthritis (carpometacarpal arthritis / CMC-1 arthritis) is a common cause of chronic thumb pain and may significantly worsen patients quality of life. The thumb is the most important digit of the hand. A diagnostic-therapeutic algorithm for CMC-1 arthritis should be widely known and based on up-to-date evidence-based medical knowledge. The literature describes many medical and surgical treatment approaches. The methods used vary between hospitals and clinics. They also depend on patients financial capabilities and many other factors.Medical (conservative) treatment appears to be effective in 60% of cases, in particular when the synergy of combining several treatment methods is taken advantage of. The most commonly performed surgical procedures in CMC-1 arthritis fall into two major groups, namely trapeziectomy or arthroplasty. However, there is no proof of superiority of one surgical treatment method over the others, and all of them have their advantages and disadvantages.This paper aims to present the most up-to-date knowledge about: (1) conservative and (2) surgical treatments for CMC-1 arthritis and (3) to propose a diagnostic-therapeutic algorithm for this condition. It is based on the latest literature (mainly works published in the last 5 years) acquired from databases such as PubMed, Clinical Key and Science Direct. The article is the second of a two-part series that presents a diagnostic-therapeutic algorithm for CMC-1 arthritis. The authors believe that it may contribute to broadening knowledge about CMC-1 arthritis, optimizing the therapeutic process and improving care for patients with CMC-1 arthritis in Poland.

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