An evaluation of the diagnostic performance of the triphasic bone scintigraphy in patients suspected of aseptic total knee arthroplasty loosening.

Background: Total Knee Arthroplasty (TKA) is a widely conducted and successful orthopedic procedure. However, aseptic loosening, a common cause of TKA failure, necessitates revision surgery. Diagnostic accuracy of triphasic bone scintigraphy, a common imaging modality for aseptic loosening detection, remains controversial.

Weight-bearing pain and implant migration, progressive radiolucencies, radiolucency more than 2 mm and subsidence on radiographs and CT are generally accepted criteria for knee arthroplasty loosening: An international Delphi consensus study.

Purpose: Establishing the diagnosis of loosening in total or unicondylar knee arthroplasty remains a challenge with different clinical and radiological signs evaluated in study designs with high risk of bias, where few or incomplete criteria are formulated for establishing the diagnosis of implant loosening. This study aimed at evaluating the variability between different clinical and radiological criteria and establish a consensus regarding clinical and radiological criteria for the diagnosis of knee arthroplasty loosening.

Methods: Highly specialized knee surgeons focusing on revision arthroplasty were invited to take part in an international panel for a Delphi consensus study.

Visible fluid motion on manipulation as the new threshold for intraoperatively determined knee arthroplasty component loosening: A Delphi study.

Purpose: There is a lack of a clear, uniform definition for intraoperatively assessed component loosening of a knee arthroplasty component, complicating the interpretation and interchangeability of results of diagnostic studies using an intraoperative observation as the reference test. The purpose of this study was to establish a consensus among specialised knee revision surgeons regarding the definition of intraoperatively determined loosening of total or unicondylar knee arthroplasty components.

Methods: Utilising the Delphi consensus method, an international panel of highly specialised knee revision surgeons was invited to participate in a three-round process.

Non-invasive quantitative assessment of induced component displacement can safely and accurately diagnose tibial component loosening in patients: A prospective diagnostic study.

Purpose: Aseptic loosening often requires major, expensive and invasive revision surgery. Current diagnostic modalities merely show indirect signs of loosening. A recent proof of concept study proposed a non-invasive technique for the quantitative and visual assessment of implant movement as a diagnostic aid for tibial component loosening.

MRI and SPECT/CT demonstrate, with low certainty of evidence, the highest diagnostic accuracy for aseptic knee arthroplasty loosening: A systematic comparative diagnostic test review and meta-analysis.

Purpose: The purpose of this study was to evaluate and compare the diagnostic accuracy of modalities used to aid the diagnosis of aseptic knee arthroplasty loosening.

Methods: A comparative diagnostic test accuracy systematic review and meta-analysis was conducted following the Cochrane and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed, EMBASE and Cochrane databases were searched for original articles evaluating diagnostic modalities up to March 2024.

Minimal but potentially clinically relevant anteroinferior position of the humeral head following traumatic anterior shoulder dislocations: A 3D-CT analysis.

In unstable shoulders, excessive anteroinferior position of the humeral head relative to the glenoid can lead to a dislocation. Measuring humeral head position could therefore be valuable in quantifying shoulder laxity. The aim of this study was to measure (1) position of the humeral head relative to the glenoid and (2) joint space thickness during passive motion in unstable shoulders caused by traumatic anterior dislocations and in contralateral uninjured shoulders.

Only Low Patients' Expectations Are Prognostic for Dissatisfaction With Performing Work-Related Knee-Straining Activities After Total Knee Arthroplasty: A Prospective Multicenter Cohort Study.

Objective: To investigate whether preoperative expectations regarding performing work-related knee-straining activities were associated with being dissatisfied 6 months after total knee arthroplasty (TKA) among working patients, and, to identify prognostic factors for being dissatisfied with performing these work-related knee-straining activities.

Design: Multicenter prospective cohort study.

Setting: Orthopedic surgery departments of 7 hospitals in the Netherlands.

Physical activity after revision knee arthroplasty including return to sport and work: a systematic review and meta-analysis including GRADE.

Background: The number of primary knee arthroplasties (KAs) performed annually is rising, especially among active, working age patients. Consequently, revision KA is also increasingly performed. Our aim was to systematically review the extent to which patients were physically active following revision KA, and the rate and timing of return to sport and work.

Promising results of an non-invasive measurement of knee implant loosening using a loading device, CT-scans and 3D image analysis.

Background: After total knee arthroplasty up to 13% requires revision surgery to address loosening. No current diagnostic modalities have a sensitivity or specificity higher than 70-80% to detect loosening, leading to 20-30% of patients undergoing unnecessary, risky and expensive revision surgery. A reliable imaging modality is required to diagnose loosening.

RSA migration of unicondylar knee arthroplasties is comparable to migration of total knee arthroplasties: A meta-analysis.

Importance: Aseptic loosening is a major cause of failure for unicondylar knee arthroplasty (UKA). In total knee arthroplasty (TKA), early migration as measured with radiostereometric analysis (RSA) is a strong predictor of late revision for aseptic loosening of the tibial component. Migration in the first two years provides information on the fixation of an implant.

Adequate return to sports and sports activities after treatment of Lisfranc injury: a meta-analysis.

Importance: Although a large number of Lisfranc injuries occur during sports, data on sports outcomes, such as return to sport (RTS) rates and times as well as level of sports activities after treatment of this injury remain limited.

Objective: The aim is to assess the RTS rates, times and the sports activity levels after different treatments of Lisfranc injuries.

Evidence Review: The electronic databases PubMed (MEDLINE), EMBASE, CDSR, DARE and CENTRAL were searched to identify relevant articles from January 1985 to July 2020.

Open Versus Endoscopic Surgical Treatment of Posterior Ankle Impingement: A Meta-analysis.

Background: Surgical treatment of symptomatic posterior ankle impingement consists of resection of the bony impediment and/or debridement of soft tissue. Historically, open techniques were used to perform surgery with good results. However, since the introduction of endoscopic techniques, advantages attributed to these techniques are shorter recovery time, fewer complications, and less pain.

Difference in orientation of the talar articular facets between healthy ankle joints and ankle joints with chronic instability.

Since both the talocrural and subtalar joints can be involved in chronic ankle instability, the present study assessed the talar morphology as this bone is the key player between both joint levels. The 3D orientation and curvature of the superior and the posteroinferior facet between subjects with chronic ankle instability and healthy controls were compared. Hereto, the talus was segmented in the computed tomography images of a control group and a chronic ankle instability group, after which they were reconstructed to 3D surface models.

Treatment type may influence degree of post-dislocation shoulder osteoarthritis: a systematic review and meta-analysis.

Purpose: Age at primary dislocation, recurrence, and glenoid bone loss are associated with development of osteoarthritis (OA). However, an overview of OA following traumatic anterior shoulder instability is lacking and it is unclear to what degree type of surgery is associated with development of OA in comparison to non-operative treatment. The aim of this study was to determine the degree of OA at long-term follow-up after non-operative and operative treatments for patients with anterior shoulder instability.

Geometrical characteristics of the symptomatic and non-symptomatic ossa trigona.

Background: Posterior ankle impingement is strongly associated with the presence of an os trigonum, however, most patients with an os trigonum will never develop symptoms. It is hypothesized that the os trigonum is larger in the symptomatic ankle than in the non-symptomatic ankle, the distance between os trigonum and tibia is smaller and there are more degenerative changes in ankles with symptoms of posterior impingement. In this study the geometrical characteristics of the ipsilateral and contralateral os trigonum are compared in patients with a bilateral os trigonum and unilateral posterior impingement symptoms.

Goal Attainment Scaling Rehabilitation Improves Satisfaction with Work Activities for Younger Working Patients After Knee Arthroplasty: Results from the Randomized Controlled ACTION Trial.

Background: Knee arthroplasty (KA) is increasingly performed in relatively young, active patients. This heterogeneous patient population often has high expectations, including work resumption and performance of knee-demanding leisure-time activities. Goal attainment scaling (GAS) may personalize rehabilitation by using patient-specific, activity-oriented rehabilitation goals.

Accuracy of Currently Available Methods in Quantifying Anterior Glenoid Bone Loss: Controversy Regarding Gold Standard-A Systematic Review.

Purpose: To determine the accuracy of glenoid bone loss-measuring methods and assess the influence of the imaging modality on the accuracy of the measurement methods.

Methods: A literature search was performed in the PubMed (MEDLINE), Embase, and Cochrane databases from 1994 to June 11, 2019. The guidelines and algorithm of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were used.

Weight, BMI and stability are risk factors associated with lateral ankle sprains and chronic ankle instability: a meta-analysis.

Importance: Lateral ankle sprains (LAS) are common in the general population and may lead to chronic ankle instability (CAI). If patients at risk could be identified, they could receive adequate and on-time treatment.

Objective: The purpose of the current review was to identify all reported intrinsic factors associated with sustaining a LAS or progressing to CAI after an initial sprain.

Accuracy of cup placement in total hip arthroplasty by means of a mechanical positioning device: a comprehensive cadaveric 3d analysis of 16 specimens.

Introduction: We tested whether a mechanical device (such as Hipsecure) to pinpoint the anterior pelvic plane (APP) as a guide can improve acetabular cup placement. To assess accuracy we asked: (1) is the APP an effective guide to position acetabular cup placement within acceptable ° of divergence from the optimal 40° inclination and 15° anteversion; (2) could a mechanical device increase the number of acetabular cup placements within Lewinnek's safe zone (i.e.

Typical Shape Differences in the Subtalar Joint Bones Between Subjects with Chronic Ankle Instability and Controls.

Bone shapes, particularly those defining the subtalar joint (STJ), have not received much attention yet as a risk factor for developing chronic ankle instability (CAI) after sustaining a lateral ankle sprain (LAS). This study aimed to compare three-dimensional (3D) shape variations in the STJ bones within individuals with CAI and healthy controls. 3D statistical shape models (SSMs) of the STJ bones were built to describe the bone shape variations observed within a population consisting of 26 individuals with unilateral CAI and 26 healthy controls.

Goal Setting and Achievement in Individualized Rehabilitation of Younger Total and Unicondylar Knee Arthroplasty Patients: A Cohort Study.

Objective: To investigate activity goals, intensity and achievement of these activity goals in younger knee arthroplasty (KA) patients, and to identify the differences between total knee arthroplasty (TKA) and unicondylar knee arthroplasty (UKA) patients.

Design: Prospective cohort study.

Setting: Department of orthopedic surgery and physical therapy practices.

Three Out of Ten Working Patients Expect No Clinical Improvement of Their Ability to Perform Work-Related Knee-Demanding Activities After Total Knee Arthroplasty: A Multicenter Study.

Purpose Three out of ten patients do not return to work after total knee arthroplasty (TKA). Patient expectations are suggested to play a key role. What are patients' expectations regarding the ability to perform work-related knee-demanding activities 6 months after TKA compared to their preoperative status? Methods A multi-center cross-sectional study was performed among 292 working patients listed for TKA.

Study on the three-dimensional orientation of the posterior facet of the subtalar joint using simulated weight-bearing CT.

The purpose of this study was to describe the normal 3D orientation and shape of the subtalar calcaneal posterior facet. This is not adequately described in current literature. In a supine position both feet of 20 healthy subjects were imaged in a simulated weight-bearing CT.