Developing a model describing voluntary residency attrition: a qualitative study.

Background: Many factors influencing residency attrition are identified in the literature, but what role these factors play and how they influence each other remains unclear. Understanding more about the interaction between these factors can provide background to put the available evidence into perspective and provide tools to reduce attrition. The aim of this study was therefore to develop a model that describes voluntary residency attrition.

[Complaints after total joint arthroplasty: caused by infection or metal hypersensitivity?].

Besides periprosthetic joint infection, metal hypersensitivity should be considered when complaints persist after total joint arthroplasty. To date, there is no consensus on the diagnosis, and believers and non-believers of metal hypersensitivity exist. The pathogenesis of metal hypersensitivity is complex and involves a type-4 delayed hypersensitivity reaction with both a cutaneous and systemic response.

[Complaints after total joint arthroplasty: caused by infection or metal hypersensitivity?].

Besides periprosthetic joint infection, metal hypersensitivity should be considered when complaints persist after total joint arthroplasty. To date, there is no consensus on the diagnosis, and believers and non-believers of metal hypersensitivity exist. The pathogenesis of metal hypersensitivity is complex and involves a type-4 delayed hypersensitivity reaction with both a cutaneous and systemic response.

Bleeding complications of thromboprophylaxis with dabigatran, nadroparin or rivaroxaban for 6 weeks after total knee arthroplasty surgery: a randomised pilot study.

Objectives: For the non-vitamin-K oral anticoagulants, data on bleeding when used for 42 days as thromboprophylaxis after total knee arthroplasty (TKA) are scarce. This pilot study assessed feasibility of a multicentre randomised clinical trial to evaluate major and clinically relevant non-major bleeding during 42-day use of dabigatran, nadroparin and rivaroxaban after TKA.

Patients And Methods: In 70 weeks, between July 2012 and November 2013, 198 TKA patients were screened for eligibility in the Martini Hospital (Groningen, the Netherlands).

Massive osteolysis due to galvanic corrosion after total knee arthroplasty: a rare cause for early revision?

A 66-year-old male underwent a total knee arthroplasty for osteoarthritis after previous anterior cruciate ligament (ACL) reconstruction. Seven years postoperatively, a symptomatic large lytic lesion was present surrounding the tibial stem. A titanium interference screw, which was used prior to fixate the Anterior Cruciate Ligament (ACL) graft, was in direct contact with the tibial component.

No Difference in Recovery of Patient-Reported Outcome and Range of Motion between Cruciate Retaining and Posterior Stabilized Total Knee Arthroplasty: A Double-Blind Randomized Controlled Trial.

Both from the perspective of the individual and from a socioeconomic point of view (e.g., return to work), it is important to have an insight into the potential differences in recovery between posterior cruciate ligament retaining (PCR) and posterior stabilized (PS) total knee arthroplasty (TKA) implants.

[Posterior shoulder dislocation; an often-missed diagnosis].

Posterior shoulder dislocation after a traumatic event is often underdiagnosed. Consequently, treatment is initiated too late and patients experience pain and loss of motion. Conventional X-ray is the standard to diagnose a posterior shoulder dislocation.

Pseudotumours, cobalt and clinical outcome in small head metal-on-metal versus conventional metal-on-polyethylene total hip arthroplasty.

Background: Metal-on-metal total hip arthroplasty (MoM THA) is associated with the formation of pseudotumours. Studies mainly concern pseudotumour formation in large head MoM THA. We performed a long-term follow-up study, comparing pseudotumour incidence in small head metal-on-metal (SHMoM) THA with conventional metal-on-polyethylene (MoP) THA.

Adaptation, validity and reliability of the modified painDETECT questionnaire for patients with subacromial pain syndrome.

Background: The identification of a neuropathic component to subacromial pain may lead to different pain management strategies. The purpose of this study was to adapt the Dutch modified painDETECT (mPDQ-NL) Knee, which discriminates between nociceptive and neuropathic pain, to fit patients with subacromial pain syndrome and subsequently assess its validity and reliability.

Methods: The mPDQ-NL Knee was adapted into the mPDQ-NL Shoulder to fit and use for patients with subacromial pain syndrome.

Flow cytometric assessment of leukocyte kinetics for the monitoring of tissue damage.

Leukocyte populations quickly respond to tissue damage, but most leukocyte kinetic studies are not based on multiparameter flow cytometry. We systematically investigated several blood leukocyte populations after controlled tissue damage. 48 patients were assigned to either an anterior or posterolateral total hip arthroplasty.

Comparing Cementing Techniques in Total Knee Arthroplasty: An In Vitro Study.

Aseptic loosening remains to be a major reason for revision in total knee arthroplasty. Cement penetration of 2 to 5 mm increases the interface strength and consequently decreases the likelihood of loosening. But despite this overall accepted optimal cement penetration, there is still a wide variety of cementing techniques used in total knee arthroplasty.

Cross-education does not improve early and late-phase rehabilitation outcomes after ACL reconstruction: a randomized controlled clinical trial.

Purpose: Limited evidence suggests that cross-education affords clinical benefits in the initial 8 weeks after anterior cruciate ligament (ACL) reconstruction, but it is unknown if such cross-education effects are reproducible and still present in later phases of rehabilitation. We examined whether cross-education, as an adjuvant to standard therapy, would accelerate the rehabilitation up to 26 weeks after ACL reconstruction by attenuating quadriceps weakness.

Methods: ACL-reconstructed patients were randomized into experimental (n = 22) and control groups (n = 21).

Shoulder arthroplasty volume standards: the more the better?

Introduction: The wide use of hip and knee arthroplasty has led to implementation of volume standards for hospitals and surgeons. For shoulder arthroplasty, the effect of volume on outcome has been researched, but no volume standard exists. This review assessed literature reporting on shoulder arthroplasty volumes and its relation to patient-reported and functional outcomes to define an annual volume threshold.

[A man with shoulder pain after a survival run].

A 31-year-old man presented with pain of the left shoulder after acute protraction of the shoulder with a forced abduction and exorotation during a survival run. Flexion and abduction were painful, as well as palpation at the medial side of the coracoid process. Isolated rupture of the minor pectoralis muscle was confirmed.

Neuropathic-like symptoms and the association with joint-specific function and quality of life in patients with hip and knee osteoarthritis.

Objective: There is an association between osteoarthritis-related pain severity and function, yet clear evidence about the sole influence of neuropathic-like symptoms on joint function and health-related quality of life (HRQoL) is lacking. Previous studies among knee OA patients show an association between neuropathic-like symptoms, lower functional status and lower quality of life, however analyses were unadjusted or had limited adjustment for influential covariates like pain intensity. The aim of this study was therefore to determine the influence of neuropathic-like symptoms-adjusted for multiple influential covariates-on joint-specific function and HRQoL in hip and knee OA patients.

Cross-education does not accelerate the rehabilitation of neuromuscular functions after ACL reconstruction: a randomized controlled clinical trial.

Purpose: Cross-education reduces quadriceps weakness 8 weeks after anterior cruciate ligament (ACL) surgery, but the long-term effects are unknown. We investigated whether cross-education, as an adjuvant to the standard rehabilitation, would accelerate recovery of quadriceps strength and neuromuscular function up to 26 weeks post-surgery.

Methods: Group allocation was randomized.

Validity of the Dutch modified painDETECT questionnaire for patients with hip or knee osteoarthritis.

Background: The modified painDETECT questionnaire (PDQ) is a self-reported questionnaire to discriminate between nociceptive and neuropathic-like pain in patients with knee/hip osteoarthritis (OA). This study aims to assess the structural and construct validity of this questionnaire.

Methods: Confirmatory factor analysis and hypothesis-testing was used.

Biographical background and origin of common eponymous terms in orthopedic surgery: anatomy and fractures in knee surgery.

An eponym is a person after whom an eponymous term is named. These eponymous terms are easy shorthand in communication between surgeons. Therefore, they are often used and hard to eradicate.

Superior return to sports rate after patellar tendon autograft over patellar tendon allograft in revision anterior cruciate ligament reconstruction.

Purpose: After revision anterior cruciate ligament reconstruction (ACLR), the rate of return to the pre-injury type of sport (RTS type) is low and graft choice might be an important factor. The aim of this study was to determine whether there is a difference in outcome after revision ACLR using a patellar tendon allograft compared to an ipsilateral patellar tendon autograft. It was hypothesized that the rate of RTS type using an ipsilateral patellar tendon autograft will be superior to using patellar tendon allograft.

Rare presentation of Brodie's abscess in the acromion process and the value of the penumbra sign.

A 17-year-old male patient presented with a swelling on his right shoulder 1 week after a fall. MRI revealed a superficial fluid collection of the acromion and trapezius muscle, with slight enhancement of the wall. The swelling burst open spontaneously after failed conservative therapy and was treated with surgical drainage and antibiotics.

An anterior cruciate ligament injury does not affect the neuromuscular function of the non-injured leg except for dynamic balance and voluntary quadriceps activation.

Purpose: The function of the anterior cruciate ligament (ACL) patients' non-injured leg is relevant in light of the high incidence of secondary ACL injuries on the contralateral side. However, the non-injured leg's function has only been examined for a selected number of neuromuscular outcomes and often without appropriate control groups. We measured a broad array of neuromuscular functions between legs of ACL patients and compared outcomes to age, sex, and physical activity matched controls.

Technical aspects of revision and functional outcome after revision of the Oxford unicompartmental knee arthroplasty.

Background: This study analysed the technical aspects of revision of the Oxford unicompartmental knee arthroplasty (OUKA) and functional results after revision.

Methods: In a historic cohort study we analysed all revised OUKAs that were primarily implanted at our clinic over a 10-year period (1998-2009). The primary aim was to investigate surgical difficulties encountered during revision surgery of the OUKA.

MRI signal intensity of anterior cruciate ligament graft after transtibial versus anteromedial portal technique (TRANSIG): design of a randomized controlled clinical trial.

Background: There are two primary surgical techniques to reconstruct the anterior cruciate ligament (ACL), transtibial (TT) technique and anteromedial portal (AMP) technique. Currently, there is no consensus which surgical technique elicits the best clinical and functional outcomes. MRI-derived measures of the signal intensity (SI) of the ACL graft have been described as an independent predictor of graft properties.

The Modified painDETECT Questionnaire for Patients with Hip or Knee Osteoarthritis: Translation into Dutch, Cross-Cultural Adaptation and Reliability Assessment.

There is a growing amount of evidence that alteration in pain processing by the peripheral and central nervous system play a role in osteoarthritis pain, leading to neuropathic-like symptoms. It is essential to identify knee and hip osteoarthritis patients with a neuropathic pain profile in order to offer such patients education and additional treatment options besides conventional pain treatment. The painDETECT Questionnaire is a self-report questionnaire developed to discriminate between nociceptive and neuropathic pain.