Publications by authors named "Ewoud R A van Arkel"

Article Synopsis
  • The study evaluated a redesigned medial meniscus prosthesis and its fixation technique after issues were noted in a prior trial.
  • Ten patients with postmeniscectomy pain received the new prosthesis, and their outcomes were tracked over 12 months using patient-reported measures and imaging.
  • While the redesign showed some clinical improvements, four prostheses failed, indicating that further work on positioning and fixation methods is needed to enhance safety and effectiveness.
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Background: The aims of this study were to describe a lateral extra-articular tenodesis (LET) using no additional hardware and compare the tibiofemoral kinematics of anterior cruciate ligament (ACL) reconstruction augmented with either the LET or a standard anatomic anterolateral ligament (ALL) reconstruction using intra-tunnel fixation.

Methods: Ten cadaveric knees were mounted on a robotic testing system and underwent a kinematic assessment of anterior tibial translation and internal tibial rotation under a simulated pivot-shift in the following states: ACL-intact, ACL-sectioned, ACL-sectioned/anterolateral complex (ALC)-sectioned, ACL-reconstructed/ALC-sectioned, ACL-reconstructed/ALL-reconstructed, and ACL-reconstructed/LET. For the LET, an iliotibial autograft was passed under the fibular collateral ligament and secured to the femur with the pull sutures of the ACL reconstruction femoral cortical suspensory fixation device, positioned at the distal ridge of Kaplan's fibers.

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Aims: The aim of this study was to evaluate the cost-effectiveness of arthroscopic partial meniscectomy versus physical therapy plus optional delayed arthroscopic partial meniscectomy in young patients aged under 45 years with traumatic meniscal tears.

Methods: We conducted a multicentre, open-labelled, randomized controlled trial in patients aged 18 to 45 years, with a recent onset, traumatic, MRI-verified, isolated meniscal tear without knee osteoarthritis. Patients were randomized to arthroscopic partial meniscectomy or standardized physical therapy with an optional delayed arthroscopic partial meniscectomy after three months of follow-up.

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Background: Considerable interindividual variation in meniscal microvascularization has been reported. The purpose of this review was to identify which patient characteristics affect meniscal microvascularization and provide a structured overview of angiogenic therapies that influence meniscal neovascularization.

Methods: A systematic literature search was undertaken using PubMed, Embase, Web of Science, Cochrane library and Emcare from inception to November 2021.

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Objective: To compare outcomes from arthroscopic partial meniscectomy versus physical therapy in young patients with traumatic meniscal tears.

Methods: We conducted a multicentre, open-labelled, randomised controlled trial in patients aged 18-45 years, with a recent onset, traumatic, MRI-verified, isolated meniscal tear without knee osteoarthritis. Patients were randomised to arthroscopic partial meniscectomy or standardised physical therapy with an optional delayed arthroscopic partial meniscectomy after 3-month follow-up.

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In this case report we present a 55-year-old female patient with acute-onset shoulder pain. X-rays of the affected shoulder showed clear levels of resorbed calcium in an enlarged subacromial bursa which is typical for the resorptive phase of calcific tendinitis of the rotator cuff.

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Purpose: The purpose of this study was to assess whether the vascularisation of the meniscus could be visualised intra-operatively using near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG) in patients undergoing total knee arthroplasty (TKA).

Methods: The anterior horn (i.e.

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Background and purpose - A guideline committee of medical specialists and a physiotherapist was formed on the initiative of the Dutch Orthopedic Association (NOV) to update the guideline Arthroscopy of the Knee: Indications and Treatment 2010. This next guideline was developed between June 2017 and December 2019. In this Part 1 we focus on the meniscus, in Part 2 on all other aspects of knee arthroscopy.

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Background and purpose - A guideline committee of medical specialists and a physiotherapist was formed on the initiative of the Dutch Orthopedic Association (NOV) to update the Guideline Arthroscopy of the Knee: Indications and Treatment 2010. This next Guideline was developed between June 2017 and December 2019. In part 1 we focused on the meniscus; this part 2 addresses all other aspects of knee arthroscopy.

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Background: It is unknown whether the treatment effects of partial meniscectomy and physical therapy differ when focusing on activities most valued by patients with degenerative meniscal tears.

Purpose: To compare partial meniscectomy with physical therapy in patients with a degenerative meniscal tear, focusing on patients' most important functional limitations as the outcome.

Study Design: Randomized controlled trial; Level of evidence, 1.

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Purpose: Evaluation of survival of meniscal allograft transplantation (MAT) and postoperative patient-reported outcome (PRO), and their association with prior interventions of the knee.

Methods: A prospective consecutive study of 109 consecutive patients who had an arthroscopic meniscal allograft transplantation (MAT) between 1999 and 2017 by a single surgeon. Patients were assessed with KOOS scores, preoperative and after a minimal follow-up of 2 years.

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The number of knee injuries in young children has risen sharply in recent years, due to more intensive participation in sporting activities by children at an increasingly lower age. This has led to more anterior cruciate ligament (ACL) ruptures. An ACL rupture has major consequences for the young athlete, but diagnosing this injury in a child can be difficult due to pain and anxiety.

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Background: Medial patellofemoral ligament (MPFL) reconstruction is associated with a high rate of complications, including recurrent instability and persistent knee pain. Technical errors are among the primary causes of these complications. Understanding the effect of adjusting patellofemoral attachments on length change patterns may help surgeons to optimize graft placement during MPFL reconstruction and to reduce graft failure rates.

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Two-stage revision anterior cruciate ligament (ACL) reconstruction is an effective way to revise suboptimal tunnel-placement allowing for proper graft fixation. However, prolonged increased laxity of the knee may increase the risk of meniscal or chondral injury. It was hypothesized that no additional meniscal or chondral lesions occur in between the two stages of the two-stage revision ACL reconstruction.

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Purpose: To elucidate the effects of various tibial and femoral attachment locations on the theoretical length changes and isometry of PCL grafts in healthy knees during in vivo weightbearing motion.

Methods: The intact knees of 14 patients were imaged using a combined magnetic resonance and dual fluoroscopic imaging technique while the patient performed a quasi-static lunge (0°-120° of flexion). The theoretical end-to-end distances of the 3-dimensional wrapping paths between 165 femoral attachments, including the anatomic anterolateral bundle (ALB), central attachment and posteromedial bundle (PMB) of the PCL, connected to an anterolateral, central, and posteromedial tibial attachment were simulated and measured.

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Purpose: To evaluate the effect of ACL deficiency on the in vivo changes in end-to-end distances and to determine appropriate graft fixation angles for commonly used tunnel positions in contemporary ACL reconstruction techniques.

Methods: Twenty-one patients with unilateral ACL-deficient and intact contralateral knees were included. Each knee was studied using a combined magnetic resonance and dual fluoroscopic imaging technique while the patients performed a dynamic step-up motion (~50° of flexion to extension).

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Background: The potential chondroprotective effect of meniscal allograft transplantation (MAT) is unclear. Subchondral bone mineral density (BMD) and subchondral bone remodeling play important roles in osteoarthritis development. Evaluation of subchondral BMD after MAT might give more insight into the potential chondroprotective effect.

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Background: Semitendinosus and gracilis tendons may regenerate after harvesting for ligament reconstruction procedures. However, predictive factors of tendon regeneration and the extent of functional recovery remain unclear.

Purpose: To identify predictive factors for hamstring tendon regeneration and to examine the morbidity of nonregenerated hamstring tendons.

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Purpose: To evaluate the in vivo anisometry and strain of theoretical anterior cruciate ligament (ACL) grafts in the healthy knee using various socket locations on both the femur and tibia.

Methods: Eighteen healthy knees were imaged using magnetic resonance imaging and dual fluoroscopic imaging techniques during a step-up and sit-to-stand motion. The anisometry of the medial aspect of the lateral femoral condyle was mapped using 144 theoretical socket positions connected to an anteromedial, central, and posterolateral attachment site on the tibia.

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Background: To assess the isometry of theoretical lateral extra-articular reconstruction (LER), we evaluated theoretical grafts attached to various points on the lateral femoral condylar area and to either Gerdy's tubercle or the anatomic attachment site of the anterolateral ligament to the tibia.

Methods: In 18 subjects, healthy knees with no history of either injury or surgery involving the lower extremity were studied. The subjects performed a sit-to-stand motion (from approximately 90° of flexion to full extension), and each knee was studied using magnetic resonance and dual fluoroscopic imaging techniques.

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Background: The treatment effect of acromioplasty for chronic subacromial pain syndrome (SAPS) on long-term shoulder function and rotator cuff deterioration has still to be determined. This study aimed to determine the long-term clinical and radiologic treatment effect of arthroscopic acromioplasty in patients with chronic SAPS.

Methods: In this double-blind, randomized clinical trial, 56 patients with chronic SAPS (median age, 47 years; age range, 31-60 years) were randomly allocated to arthroscopic bursectomy alone or to bursectomy combined with acromioplasty and were followed up for a median of 12 years.

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Article Synopsis
  • Subacromial pain syndrome (SAPS) and scapular dyskinesis are linked, with the hypothesis that pain causes asymmetrical shoulder movement, potentially improving after anesthesia.
  • An observational study of 34 patients revealed that those with SAPS had increased internal rotation in their affected shoulder compared to the healthy side, and that anesthesia did improve some kinematic measures, though not enough for complete symmetry.
  • Results showed a significant connection between lower scapular upward rotation and higher pain levels before treatment, indicating that anesthesia alone may not effectively normalize shoulder motion.
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Purpose: To measure the in vivo anterolateral ligament (ALL) length change in healthy knees during step-up and sit-to-stand motions.

Methods: Eighteen healthy knees were imaged using magnetic resonance and dual fluoroscopic imaging techniques during a step-up and sit-to-stand motion. The ALL length change was measured using the shortest three-dimensional wrapping path, with its femoral attachment located slightly anterior-distal (ALL-Claes) or posterior-proximal (ALL-Kennedy) to the fibular collateral ligament attachment.

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The objective of the study was the determination of the intra- and interobserver agreement of three magnetic resonance imaging (MRI) criteria for reparability: a peripheral rim smaller than 4 mm, a tear longer than 10 mm, and homogenous aspect of meniscal tissue. In two rounds with an interval of at least 6 weeks, three orthopedic surgeons and three musculoskeletal radiologists studied the preoperative MRI scans of 63 patients with a longitudinal full-thickness medial or lateral meniscal tear. All patients had an arthroscopic meniscal repair.

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