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| 2. |
- Johansson, Anders, et al.
(författare)
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Spectroscopic Measurement of Cartilage Thickness in Arthroscopy: Ex Vivo Validation in Human Knee Condyles
- 2012
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Ingår i: Arthroscopy. - : WB Saunders. - 0749-8063 .- 1526-3231. ; 28:10, s. 1513-1523
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the accuracy of articular cartilage thickness measurement when implementing a new technology based on spectroscopic measurement into an arthroscopic camera. Methods: Cartilage thickness was studied by ex vivo arthroscopy at a number of sites (N = 113) in human knee joint osteoarthritic femoral condyles and tibial plateaus, removed from 7 patients undergoing total knee replacement. The arthroscopic image spectral data at each site were used to estimate cartilage thickness. Arthroscopically derived thickness values were compared with reference cartilage thickness as measured by 3 different methods: needle penetration, spiral computed tomography scanning, and geometric measurement after sample slicing. Results: The lowest mean error (0.28 to 0.30 mm) in the regression between arthroscopic and reference cartilage thickness was seen for reference cartilage thickness less than 1.5 mm. Corresponding values for cartilage thickness less than 2.0 and 2.5 mm were 0.32 to 0.40 mm and 0.37 to 0.47 mm, respectively. Cartilage thickness images-created by pixel-by-pixel regression model calculations applied to the arthroscopic images-were derived to demonstrate the clinical use of a camera implementation. Conclusions: On the basis of this investigation on osteoarthritic material, when one is implementing the spectroscopic method for estimating cartilage thickness into an arthroscopic camera, errors in the range of 0.28 to 0.30 mm are expected. This implementation does not, however, influence the fact that the spectral method performs less well in the cartilage thickness region from 1.5 to 2.5 mm and cannot assess cartilage thicker than 2.5 mm. Clinical Relevance: Imaging cartilage thickness directly in the arthroscopic camera video stream could serve as an interesting image tool for in vivo cartilage quality assessment, in connection with cartilage diagnosis, repair, and follow-up.
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- Järvinen, Teppo L. N., et al.
(författare)
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Anterior cruciate ligament graft fixation--a myth busted?
- 2010
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Ingår i: Arthroscopy. - : Elsevier BV. - 1526-3231. ; 26:5, s. 681-684
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Tidskriftsartikel (refereegranskat)abstract
- Anterior cruciate ligament graft fixation has become one of the most investigated topics in the sports traumatology literature. With over 400 publications within the past decade, a plausible explanation for the popularity of the topic would be that anterior cruciate ligament graft fixation represents an obvious clinical problem. Yet this does not seem to be the case. We set out to analyze the veracity of the notion that the fixation site is the weak link in a reconstructed knee in the early postoperative period. A mere temporal association is found between the first clinical reports on increased anterior tibial translation relative to the femur with soft-tissue grafts and the first pullout studies reporting lower ultimate failure loads with such grafts. This association was sufficient to convince the orthopaedic community at large that actual causality exists between soft-tissue graft fixation failure and increased knee laxity during healing. Thus the concept of “graft slippage” was born. Even with the imminent risk of being misconstrued as contentious, we submit that the entire concept of graft slippage is a myth, founded on poor scientific practice and affected by commercial bias. As a way forward, clinically important phenomena should be demonstrated through experiments with clear and sound clinical endpoints. As for preclinical studies, although they are indisputably helpful in the elaboration of such phenomena, serious hazards lie in declaring them a sufficient scientific basis for new research or, worse, for clinical standards of care. More importantly, no matter how sophisticated or fascinating their methodology, preclinical studies do not relieve us from the necessity and duty of proving our theories, whenever possible, with randomized controlled trials. Using the search terms “ACL fixation” and “ACL graft fixation,” the Medline literature search results in nearly 600 studies during the last 26 years (1983 to January 2010), of which over 400 have been published within the past decade. As such, anterior cruciate ligament (ACL) graft fixation is among the most investigated topics in recent sports medicine literature.
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| 4. |
- Karlsson, Jón, 1953, et al.
(författare)
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A practical guide to research: design, execution, and publication.
- 2011
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Ingår i: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. - : Elsevier BV. - 1526-3231. ; 27:4 Suppl
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Tidskriftsartikel (refereegranskat)
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| 5. |
- Kvist, Joanna, et al.
(författare)
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Results From the Swedish National Anterior Cruciate Ligament Register.
- 2014
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Ingår i: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. - : Elsevier BV. - 1526-3231 .- 0749-8063. ; 30:7, s. 803-810
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the study was to analyze the baseline variables and clinical outcomes for almost 24,000 patients entered into the Swedish National ACL Register between January 2005 and December 2012.
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| 6. |
- Stener, Sven, 1953, et al.
(författare)
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Anterior cruciate ligament reconstruction reduces bonemineral areal mass.
- 2013
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Ingår i: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. - : Elsevier BV. - 1526-3231. ; 29:11, s. 1788-95
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to prospectively follow bone mineral areal mass (BMA) changes in the calcaneii, hips,and lumbar spine after anterior cruciate ligament (ACL) reconstruction using hamstring tendon autografts.
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| 7. |
- van Eck, C. F., et al.
(författare)
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"Anatomic" anterior cruciate ligament reconstruction: a systematic review of surgical techniques and reporting of surgical data
- 2010
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Ingår i: Arthroscopy. - : Elsevier BV. - 1526-3231. ; 26:9 Suppl
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this systematic review was to evaluate studies published on anatomic double-bundle anterior cruciate ligament (ACL) reconstruction. METHODS: A systematic electronic search was performed by use of the Medline and Embase databases. Studies that were published from January 1995 to April 2009 were included. The selection criteria were studies that reported on a surgical technique for "anatomic double-bundle ACL reconstruction" on skeletally mature living human subjects and were written in English. Data collected and analyzed included a variety of surgical data. Tables were created to provide an overview of surgical techniques for anatomic ACL reconstruction. RESULTS: Seventy-four studies were included in this review. Some surgical factors were adequately reported in the majority of the articles: visualizing the native ACL insertion sites, placing the tunnels in the footprint, graft type, and fixation method. However; ACL insertion site measurement, femoral intercondylar notch measurement, individualization of surgery, and intraoperative/postoperative imaging were poorly reported. The most variety was seen in knee flexion angle during femoral tunnel drilling and tensioning pattern of the grafts. CONCLUSIONS: For most surgical data, there was a gross under-reporting of specific operative technique data. We believe that the details of an "anatomic" operative technique are crucial for the valid interpretations of the outcomes. Thus we encourage authors to report their surgical technique in a specific and standardized fashion.
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