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- Alentorn-Geli, Eduard, et al.
(author)
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Factors predictive of poorer outcomes in the surgical repair of multiligament knee injuries.
- 2019
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In: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347. ; 27:2, s. 445-459
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Journal article (peer-reviewed)abstract
- To investigate the influence of injury and treatment factors on clinical/functional outcomes in multiligament knee injuries (MLKI).Thirty-nine consecutive patients with confirmed and surgically treated MLKI who met inclusion criteria were scheduled for a follow-up visit to obtain: SF-12 and subjective feeling of normalcy between the operated and healthy knee, and IKDC, active range of motion (ROM), and stability exam (Lachman test, posterior drawer, and dial test at 30°). A chart review was used to obtain data on injury and treatment factors.The postoperative mean (SD) outcomes were: IKDC score 62.7 (25.9), flexion-extension ROM 125° (29°), and percentage of normalcy 74% (20%). The postoperative normal/nearly normal stability exam was: Lachman test 36 (95%) patients, posterior drawer at 90° 38 (97%) patients, and dial test of 39 (100%) patients. There were 24 (61.5%) and 23 (59%) patients with complications and reoperations, respectively. The presence of bicruciate injuries was associated with worse Lachman (p=0.03) and posterior drawer tests (p=0.03). Presence of injury to meniscal structures was associated with worse Lachman test (p=0.03), lower percentage of normalcy (p=0.02) and extension lag (p=0.04). Injury to cartilage structures was associated with worse IKDC scores (p=0.04). IKDC was lower in cases of posterolateral corner reconstruction (p=0.03) and use of allograft tendons for reconstruction (p=0.02); ROM was lower in allograft reconstruction (p=0.02) and need for meniscal repair (p = 0.01). Bicruciate reconstruction led to worst posterior drawer test (p=0.006).The outcomes of MLKI might be negatively influenced by bicruciate ligament, meniscal, and cartilage injuries; with regards to treatment characteristics, need for posterolateral corner or bicruciate ligament reconstruction, use of allografts, or need for meniscal repair may similarly diminish outcomes. While surgical treatment provides good overall function, ROM and stability, it rarely results in a "normal" knee and the chances of complications and reoperations are high.Cross-sectional comparative study, Level III.
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- Ruhl, Henry A., et al.
(author)
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Societal need for improved understanding of climate change, anthropogenic impacts, and geo-hazard warning drive development of ocean observatories in European Seas
- 2011
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In: Progress In Oceanography. ; 91:1, s. 1-33
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Journal article (peer-reviewed)abstract
- Society’s needs for a network of in situ ocean observing systems cross many areas of earth and marine science. Here we review the science themes that benefit from data supplied from ocean observatories. Understanding from existing studies is fragmented to the extent that it lacks the coherent long-term monitoring needed to address questions at the scales essential to understand climate change and improve geo-hazard early warning. Data sets from the deep sea are particularly rare with long-term data available from only a few locations worldwide. These science areas have impacts on societal health and well-being and our awareness of ocean function in a shifting climate. Substantial efforts are underway to realise a network of open-ocean observatories around European Seas that will operate over multiple decades. Some systems are already collecting high-resolution data from surface, water column, seafloor, and sub-seafloor sensors linked to shore by satellite or cable connection in real or near-real time, along with samples and other data collected in a delayed mode. We expect that such observatories will contribute to answering major ocean science questions including: How can monitoring of factors such as seismic activity, pore fluid chemistry and pressure, and gas hydrate stability improve seismic, slope failure, and tsunami warning? What aspects of physical oceanography, biogeochemical cycling, and ecosystems will be most sensitive to climatic and anthropogenic change? What are natural versus anthropogenic changes? Most fundamentally, how are marine processes that occur at differing scales related? The development of ocean observatories provides a substantial opportunity for ocean science to evolve in Europe. Here we also describe some basic attributes of network design. Observatory networks provide the means to coordinate and integrate the collection of standardised data capable of bridging measurement scales across a dispersed area in European Seas adding needed certainty to estimates of future oceanic conditions. Observatory data can be analysed along with other data such as those from satellites, drifting floats, autonomous underwater vehicles, model analysis, and the known distribution and abundances of marine fauna in order to address some of the questions posed above. Standardised methods for information management are also becoming established to ensure better accessibility and traceability of these data sets and ultimately to increase their use for societal benefit. The connection of ocean observatory effort into larger frameworks including the Global Earth Observation System of Systems (GEOSS) and the Global Monitoring of Environment and Security (GMES) is integral to its success. It is in a greater integrated framework that the full potential of the component systems will be realised.
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