Change in patient-reported outcomes in patients with and without mechanical symptoms undergoing arthroscopic meniscal surgery: A prospective cohort study.

OBJECTIVE: Patients with degenerative or traumatic meniscal tears are at high risk of developing knee osteoarthritis. We investigated if younger (≤40 years) and older (>40 years) patients with preoperative mechanical symptoms (MS) improved more in patient-reported outcomes after meniscal surgery than those without MS. DESIGN: Patients from Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing arthroscopic surgery for a meniscal tear completed online questionnaires before surgery, and at 12 and 52 weeks follow-up. Questionnaires included self-reported presence of MS (i.e., sensation of catching and/or locking) and the Knee injury and Osteoarthritis Outcome Score (KOOS). We analyzed between-group differences in change in KOOS4 from baseline to 52 weeks, using an adjusted mixed linear model. RESULTS: 150 younger patients (mean age 31 (SD 7), 67% men) and 491 older patients (mean age 54 (SD 9), 53% men) constituted the baseline cohorts. Patients with MS generally had worse self-reported outcomes before surgery. At 52 weeks follow-up, younger patients with preoperative MS had improved more in KOOS4 scores than younger patients without preoperative MS (adjusted mean difference 10.5, 95% CI: 4.3, 16.6), but did not exceed the absolute postoperative KOOS4 scores observed for those without MS. No difference in improvement was observed between older patients with or without MS (adjusted mean difference 0.7, 95% CI: -2.6, 3.9). CONCLUSIONS: Younger patients (≤40 years) with preoperative MS experienced greater improvements after arthroscopic surgery compared to younger patients without MS. Our observational study result needs to be confirmed in randomized trials.

One or more bound planets per Milky Way star from microlensing observations.

Most known extrasolar planets (exoplanets) have been discovered using the radial velocity or transit methods. Both are biased towards planets that are relatively close to their parent stars, and studies find that around 17-30% (refs 4, 5) of solar-like stars host a planet. Gravitational microlensing, on the other hand, probes planets that are further away from their stars. Recently, a population of planets that are unbound or very far from their stars was discovered by microlensing. These planets are at least as numerous as the stars in the Milky Way. Here we report a statistical analysis of microlensing data (gathered in 2002-07) that reveals the fraction of bound planets 0.5-10 AU (Sun-Earth distance) from their stars. We find that 17(+6)(-9)% of stars host Jupiter-mass planets (0.3-10 M(J), where M(J) = 318 M(⊕) and M(⊕) is Earth's mass). Cool Neptunes (10-30 M(⊕)) and super-Earths (5-10 M(⊕)) are even more common: their respective abundances per star are 52(+22)(-29)% and 62(+35)(-37)%. We conclude that stars are orbited by planets as a rule, rather than the exception.

Breast cancer recurrence after reoperation for surgical bleeding.

BACKGROUND: Bleeding activates platelets that can bind tumour cells, potentially promoting metastatic growth in patients with cancer. This study investigated whether reoperation for postoperative bleeding is associated with breast cancer recurrence. METHODS: Using the Danish Breast Cancer Group database and the Danish National Patient Register (DNPR), a cohort of women with incident stage I-III breast cancer, who underwent breast-conserving surgery or mastectomy during 1996-2008 was identified. Information on reoperation for bleeding within 14 days of the primary surgery was retrieved from the DNPR. Follow-up began 14 days after primary surgery and continued until breast cancer recurrence, death, emigration, 10 years of follow-up, or 1 January 2013. Incidence rates of breast cancer recurrence were calculated and Cox regression models were used to quantify the association between reoperation and recurrence, adjusting for potential confounders. Crude and adjusted hazard ratios according to site of recurrence were calculated. RESULTS: Among 30 711 patients (205 926 person-years of follow-up), 767 patients had at least one reoperation within 14 days of primary surgery, and 4769 patients developed breast cancer recurrence. Median follow-up was 7·0 years. The incidence of recurrence was 24·0 (95 per cent c.i. 20·2 to 28·6) per 1000 person-years for reoperated patients and 23·1 (22·5 to 23·8) per 1000 person-years for non-reoperated patients. The overall adjusted hazard ratio was 1·06 (95 per cent c.i. 0·89 to 1·26). The estimates did not vary by site of breast cancer recurrence. CONCLUSION: In this large cohort study, there was no evidence of an association between reoperation for bleeding and breast cancer recurrence.

Metformin use and risk of lactic acidosis in people with diabetes with and without renal impairment: a cohort study in Denmark and the UK.

AIMS: To assess risk of lactic acidosis among metformin users compared with other glucose-lowering agent users, according to renal function. METHODS: Using routine registries and databases, we conducted a cohort study. Of 43 580 metformin and 37 788 other glucose-lowering agent users in northern Denmark and 102 688 metformin and 28 788 other glucose-lowering agent users in the UK during 2001-2011, we identified lactic acidosis using diagnostic codes. We calculated the incidence rates of lactic acidosis in metformin and other glucose-lowering agent users overall and according to baseline estimated GFR (eGFR) levels. RESULTS: In Denmark, the incidence rates of lactic acidosis were 11.6 (95% CI 7.0-18.1) and 1.8 (95% CI 0.4-5.4) per 100 000 person-years of metformin use and of other glucose-lowering agent use, respectively. In the UK, the corresponding lactic acidosis incidence rates were 6.8 (95% CI 4.6-9.6) and 1.0 (95% CI 0.01-5.7) per 100 000 person-years of metformin use and of other glucose-lowering agent use. The incidence rates increased with decreasing baseline eGFR in both countries. Of the metformin-exposed people with lactic acidosis, 37% in Denmark and 34% in the UK experienced a decline in renal function in the year before the diagnosis. CONCLUSIONS: Risk of lactic acidosis was higher in metformin users than in other glucose-lowering agent users, and increased with decreasing eGFR, although this could be attributable to surveillance bias; however, diagnosed lactic acidosis was rare and can occur regardless of renal function.

Soil greenhouse gas emissions from drained and rewetted agricultural bare peat mesocosms are linked to geochemistry.

In view of climate considerations regarding the management of peatlands, there is a need to assess whether rewetting can mitigate greenhouse gas (GHG) emissions, and notably how site-specific soil-geochemistry will influence differences in emission magnitudes. However, there are inconsistent results regarding the correlation of soil properties with heterotrophic respiration (Rh) of carbon dioxide (CO2), methane (CH4), and nitrous oxide (N2O) from bare peat. In this study, we determined 1) soil-, and site-specific geochemical components as drivers for emissions from Rh on five Danish fens and bogs, and 2) emission magnitudes under drained and rewetted conditions. For this, a mesocosm experiment was performed under equal exposure to climatic conditions and water table depths controlled to either -40 cm, or -5 cm. For the drained soils, we found that annual cumulative emissions, accounting for all three gases, were dominated by CO2, contributing with, on average, 99 % to a varying global warming potential (GWP) of 12.2-16.9 t CO2eq ha-1 yr-1. Rewetting lowered annual cumulative emissions from Rh by 3.2-5.1 t CO2eq ha-1 yr-1 for fens and bogs, respectively, despite a high variability of site-specific CH4 emissions, contributing with 0.3-3.4 t CO2 ha-1 yr-1 to the GWP. Overall, analyses using generalized additive models (GAM) showed that emission magnitudes were well explained by geochemical variables. Under drained conditions, significant soil-specific predictor variables for CO2 flux magnitudes were pH, phosphorus (P), and the soil substrate's relative water holding capacity (WHC). When rewetted, CO2 and CH4 emissions from Rh were affected by pH, WHC, as well as contents of P, total carbon and nitrogen. In conclusion, our results found the highest GHG reduction on fen peatlands, further highlighting that peat nutrient status and acidity, and the potential availability of alternative electron acceptors, might be used as proxies for prioritising peatland areas for GHG mitigation efforts by rewetting.

Discovery of a cool planet of 5.5 Earth masses through gravitational microlensing.

In the favoured core-accretion model of formation of planetary systems, solid planetesimals accumulate to build up planetary cores, which then accrete nebular gas if they are sufficiently massive. Around M-dwarf stars (the most common stars in our Galaxy), this model favours the formation of Earth-mass (M(o)) to Neptune-mass planets with orbital radii of 1 to 10 astronomical units (au), which is consistent with the small number of gas giant planets known to orbit M-dwarf host stars. More than 170 extrasolar planets have been discovered with a wide range of masses and orbital periods, but planets of Neptune's mass or less have not hitherto been detected at separations of more than 0.15 au from normal stars. Here we report the discovery of a 5.5(+5.5)(-2.7) M(o) planetary companion at a separation of 2.6+1.5-0.6 au from a 0.22+0.21-0.11 M(o) M-dwarf star, where M(o) refers to a solar mass. (We propose to name it OGLE-2005-BLG-390Lb, indicating a planetary mass companion to the lens star of the microlensing event.) The mass is lower than that of GJ876d (ref. 5), although the error bars overlap. Our detection suggests that such cool, sub-Neptune-mass planets may be more common than gas giant planets, as predicted by the core accretion theory.

Osteonecrosis of the jaw among cancer patients in Denmark: risk and prognosis.

Osteonecrosis of the jaw (ONJ) is a serious complication of anti-resorptive therapy used in the treatment of multiple myeloma and cancerous bone metastases. In this study, patients with either multiple myeloma or solid tumours with a simultaneous or subsequent record of anti-resorptive treatment or bone metastases were identified using population-based medical registries. These patients were followed for the outcome of ONJ. Considering death as a competing risk, the cumulative incidence of ONJ was estimated, overall and by cancer site. Patients who developed ONJ were followed for the outcome of death overall and by several risk factors for ONJ. A total of 33,975 cancer patients fulfilling the inclusion criteria were identified; 233 incidents of ONJ and a cumulative incidence of 1.9% (95% confidence interval 1.6-2.3%) over a maximum follow-up time of 7.5 years were observed. The 5-year cumulative incidence was 1.3% (95% confidence interval 1.2-1.6%) and varied by cancer site. There were 126 deaths among cancer patients with ONJ over a maximum follow-up time of 6.4 years, resulting in a 5-year mortality of 91% (95% confidence interval 81-97%). Mortality among patients with ONJ varied by cancer site, osteonecrosis stage, and by history of trauma to the mucosa.

Overall risk and risk factors for metachronous peritoneal metastasis after colorectal cancer surgery: a nationwide cohort study.

BACKGROUND: This study aimed to identify the cumulative incidence and risk factors of metachronous peritoneal metastasis (M-PM) from colorectal cancer in patients who had intended curative treatment. METHODS: Patients with colorectal cancer were identified using the Danish Colorectal Cancer Group database for 2006-2015. The Danish Pathology Registry and the Danish National Patient Registry were used to identify M-PM to 2017. Risk factors were estimated by multivariable absolute risk regression, treating death and other cancers as competing risks. Overall risk and risk differences (RDs) were estimated at 1, 3 and 5 years. RESULTS: In 22 586 patients with colorectal cancer, the overall risk of M-PM was reported to be 0·9 (95 per cent c.i. 0·8 to 1·0) per cent at 1 year, 1·9 (1·8 to 2·1) per cent at 3 years and 2·2 (2·0 to 2·4) per cent at 5 years. Advanced tumour category ((y)pT4 versus (y)pT1) increased the RD of both M-PM (2·9 (95 per cent c.i. 2·1 to 3·7) at 1 year and 6·0 (4·9 to 7·2) at 3 years) and lymph node involvement ((y)pN2 versus (y)pN0) (2·5 (1·8 to 3·2) at year and 4·3 (3·2 to 5·3) at 3 years). No further increase in risk was observed at 5 years. In a subanalysis, tumour-involved resection margin (R1 versus R0) was associated with M-PM with a RD of 3·9 (1·6 to 6·2) at 1 year and 5·9 (2·6 to 9·3) at 3 years. CONCLUSION: The overall risk of M-PM in patients with colorectal cancer is low, but is increased in advanced T and N status. Follow-up of at least 3 years after colorectal cancer surgery may be necessary, given the potential curative treatment of early diagnosed M-PM.

ANTECEDENTES: Este estudio tuvo como objetivo identificar la incidencia acumulada y los factores de riesgo de metástasis peritoneales metacrónicas (metachronous peritoneal metastases, M-PM) del cáncer colorrectal en pacientes que se sometieron al tratamiento curativo previsto. MÉTODOS: Se identificaron los pacientes con cáncer colorrectal a partir de la base de datos del grupo danés de cáncer colorrectal (Danish Colorectal Cancer Group) durante el periodo 2006-2015. El Registro Danés de Patología (Danish Pathology Registry) y el Registro Nacional Danés de Pacientes (Danish National Patient Registry) se utilizaron para identificar los casos de M-PM hasta el 2017. Los factores de riesgo se estimaron mediante una regresión de riesgo absoluto multivariable, tratando la muerte y otros tipos de cáncer como riesgos competitivos. El riesgo general y las diferencias de riesgo (risk differences, RD) se estimaron a 1, 3 y 5 años. RESULTADOS: De los 22.586 pacientes con CCR, el riesgo global de M-PM fue del 0,9% (i.c. del 95%: 0,8 a 1,0) al año, 1,9 (i.c. del 95%: 1,8 a 2,1) a los 3 años y 2,2 (i.c. del 95%: 2,0 a 2.4) después de 5 años. El estadio T tumoral avanzado ((y) pT4 versus (y) pT1) aumentó el riesgo de M-PM, DR a 1 año: 2,9% (i.c. del 95%: 2,1 a 3,), 3 años: 6,0 (i.c. 95% 4,9 a 7,2), así como la afectación de los ganglios linfáticos ((y) pN2 versus (y) pN0), 1 año: 2,5 (i.c. 95% 1,8 a 3,2), 3 años: 4,3 (i.c. 95% 3,2 a 5,3). No se observó un aumento adicional en la DR después de 5 años. Los márgenes de resección tumoral (R1 versus R0) se asociaron con una DR a 1 año de 3,9 (i.c. del 95% 1,6 a 6,2), y a 3 años de 5,9 (i.c. del 95% 2,6 a 9,3) de riesgo de M-PM en un subanálisis. CONCLUSIÓN: El riesgo global de M-PM en el cáncer colorrectal en pacientes es bajo, pero aumenta en las categorías de estadios T y N avanzados. Puede ser necesario un seguimiento de al menos 3 años después de la cirugía de CCR, dado el tratamiento potencialmente curativo de la M-PM diagnosticada precozmente.

Energy balance and cost-benefit analysis of biogas production from perennial energy crops pretreated by wet oxidation.

Perennial crops need far less energy to plant, require less fertilizer and pesticides, and show a lower negative environmental impact compared with annual crops like for example corn. This makes the cultivation of perennial crops as energy crops more sustainable than the use of annual crops. The conversion into biogas in anaerobic digestion plants shows however much lower specific methane yields for the raw perennial crops like miscanthus and willow due to their lignocellulosic structure. Without pretreatment the net energy gain is therefore lower for the perennials than for corn. When applying wet oxidation to the perennial crops, however, the specific methane yield increases significantly and the ratio of energy output to input and of costs to benefit for the whole chain of biomass supply and conversion into biogas becomes higher than for corn. This will make the use of perennial crops as energy crops competitive to the use of corn and this combination will make the production of biogas from energy crops more sustainable.

Risk factors for extended-spectrum ß-lactamase-producing Escherichia coli urinary tract infection in the community in Denmark: a case-control study.

OBJECTIVE: To verify the role of proton pump inhibitors (PPI) and nitrofurantoin, which have appeared as novel risk factors for carriage of extended-spectrum ß-lactamase (ESBL) -producing Escherichia coli, as risk factors for ESBL E. coli urinary tract infection (UTI). We included known risk factors to ascertain whether our findings are comparable with those of previous studies. METHODS: Population-based case-control study including 339 cases with community-onset ESBL E. coli UTI in 2007-2012, 3390 non-ESBL E. coli UTI controls and 3390 population controls. We investigated potential risk factors by estimating ORs and 95% CIs adjusting for sex, age and co-morbidity. RESULTS: Comparing cases with non-ESBL E. coli UTI, PPI use yielded an OR of 1.6 (95% CI 1.2-2.0) and antibiotic exposure gave an OR of 1.4 (95% CI 1.1-1.8); these were driven by nitrofurantoin (OR 1.8; 95% CI 1.3-2.6) and macrolides (OR 1.7; 95% CI 1.2-2.3). Other risk factors included previous hospitalization with one or two and more than two hospitalizations versus none yielding ORs of 1.9 (95% CI 1.4-2.5) and 4.6 (95% CI 3.2-6.8), recent surgery (OR 2.0; 95% CI 1.5-2.8), renal disease (OR 2.2; 95% CI 1.4-3.4), chronic pulmonary disease (OR 1.4; 95% CI 1.0-2.0) and cancer (OR 1.5; 95% CI 1.1-2.1). Comparing cases with population controls, we found that most risk factors were also risk factors for non-ESBL UTI. CONCLUSIONS: ESBL E. coli UTI were associated with previous hospitalization and surgery. Nitrofurantoin and macrolides augmented the risk. PPIs had a moderate effect but may be important facilitators of ESBL carriage due to their widespread use.

Injuries in badminton.

Though badminton is one of the most widely played sports in the world, it has received little sports medical interest. Based on the few existing studies on injuries in badminton, compared to other sports it is of relatively low risk and dominated by overuse injuries. The injury duration is relatively long, but only a few working days are lost. Anatomically, most injuries are localised to the foot and ankle. The single most frequent injuries are Achilles tendinitis and tennis elbow. Rupture of the Achilles tendon is a rare injury, which is typically seen in older recreational players. When the time of exposure is taken into account men are found to have a higher injury risk than women, and recreational players a higher injury risk than elite players. In contrast to most other sports the relative injury risk is higher during training than in competition. Based on suggested causes of injury and injury mechanisms, together with the known injury pattern in badminton the following preventive matters are suggested: (a) changes in the badminton shoe, towards a higher heel, with shock absorption and a stiffer anatomically fitting heel counter; (b) adjustment of the friction between the individual shoe-soles and playing surfaces; and (c) specific badminton training including stretching and strengthening of the triceps surae and the muscles involved in the internal and external rotation of the shoulder and elbow during the badminton strokes.

CABG shortly after AMI treated with thrombolysis: an analysis of the surgical group and a comparison with PTCA in the DANAMI study. Danish multicenter randomized study of invasive versus conservative treatment in patients with inducible ischemia after thrombolysis in acute myocardial infarction.

OBJECTIVE: To present surgical results of the DANAMI study comparing conservative and invasive treatment of postinfarction myocardial ischaemia and to compare these with percutaneous transluminal angioplasty (PTCA) which was the alternative invasive treatment in that study. METHODS: A group of 413 patients with verified acute myocardial infarction treated with thrombolysis within 12 h of the onset of symptoms, who demonstrated postinfarction myocardial ischaemia were treated with coronary artery bypass grafting (CABG) or PTCA. Patients with left main lesions, three-vessel disease, two-vessel disease with more than three stenoses and patients with occlusions of a non-infarct related vessel had primary CABG. Patients with 1- and 2-vessel disease with not more than a total of three stenoses had PTCA. In case of failed PTCA patients had secondary CABG. The median distance from AMI to CABG was 45 days. PTCA was performed at a mean of 39 days after the infarction. RESULTS: A total of 147 patients had CABG and 266 had PTCA. The operative mortality for CABG was 1.4%. No PTCA patients died in relation to the procedure, 0.8% developed acute myocardial infarction as a consequence of the procedure, 1.5% had acute CABG and 3.5% elective CABG due to failed PTCA. In spite of more severe coronary artery disease among the CABG patients there was no difference in survival at 2.4 years. The CABG group had significantly fewer episodes of unstable angina, 10.2% versus 25.6% (P = 0.0002). No CABG patients had re-do revascularisation at 2.4 years follow-up versus 15.4% of the PTCA patients. At 3 years 80% of the CABG patients were free of angina compared to the 61% of the PTCA group (P < 0.0001). CONCLUSION: Low morbidity and mortality justifies the deferred elective revascularisation in patients with postinfarction myocardial ischaemia even in patients with silent ischaemia. There is no difference in survival at 2.4 years between CABG and PTCA but CABG offers more lasting results concerning incidence of stable and unstable angina than PTCA, which, however, is a valuable alternative in patients with less severe coronary artery disease.

Olfactory and quantitative analysis of aroma compounds in elder flower (Sambucus nigra L.) drink processed from five cultivars.

Fresh elder flowers (Sambucus nigra L.) were extracted with an aqueous solution containing sucrose, peeled lemon slices, tartaric acid, and sodium benzoate to make elder flower syrup. Aroma compounds emitted from the elder flower syrup were collected by the dynamic headspace technique and analyzed by GC-FID and GC-MS. A total of 59 compounds were identified, 18 of which have not previously been detected in elder flower products. The concentrations of the identified volatiles were measured in five elder cultivars, Allesoe, Donau, Sambu, Sampo, and Samyl, and significant differences were detected among cultivars in the concentration levels of 48 compounds. The odor of the volatiles was evaluated by the GC-sniffing technique. cis-Rose oxide, nerol oxide, hotrienol, and nonanal contributed to the characteristic elder flower odor, whereas linalool, alpha-terpineol, 4-methyl-3-penten-2-one, and (Z)-beta-ocimene contributed with floral notes. Fruity odors were associated with pentanal, heptanal, and beta-damascenone. Fresh and grassy odors were primarily correlated with hexanal, hexanol, and (Z)-3-hexenol.

Achillodynia and loss of heel pad shock absorbency.

The heel pad, with its specially organized elastic adipose tissue, and the importance of heel pad shock absorption loss (soft heel pads) in the pathophysiology of achillodynia (particularly in heel strikers) is described and illustrated by case histories of three athletes. All had unusual, soft, flattened heel pads; all were heelstrikers; and all were successfully treated with added external heel shock absorption. A diagnostic method to evaluate the shock absorbing ability of the heel pad is the "visual compressibility index" calculated on the basis of x-ray films of the heel, loaded and unloaded by body weight.

Body load in heel-strike running: the effect of a firm heel counter.

The effect of a firm heel counter in the shoe was studied in 11 athletes during submaximal heel-strike running on a treadmill under standardized conditions. The runners were tested in identical shoes with and without the distal 2 cm of the firm heel counter. Body load was expressed by absolute and relative VO2, surface EMG on the right leg, and g-force registration from an accelerometer below the right tibial tuberosity. The heel counter caused a 2.4% significant decrease in VO2, a reduction in musculoskeletal transients, and a decrease in the activity of the triceps surae and quadriceps muscles at heel strike. The changes found are expressions of kinematic adaptations in the body to increased or decreased load and provide functional evidence for the loading factor in the pathophysiology of overuse injuries.

Injuries among young soccer players.

We registered all new injuries among 496 male youth soccer players, aged 12 to 18 years, during the course of one year. The incidence of injury was 3.7 injuries per 1000 hours of soccer per player. The incidence increased with age, and at the higher ages within the youth players, approached the incidence rate of senior players (age greater than or equal to 18 years). Seventy percent of the injuries were located in the lower extremities, particularly the knee (26%) and ankle (23%). Back pain occurred in 14% of players. Fractures, which accounted for 4% of injuries, were most often in the upper extremities. We conclude that youth soccer is a relatively low-risk sport with an injury pattern that differs slightly from that of senior players.

Operative versus nonoperative treatment of Achilles tendon rupture. A prospective randomized study and review of the literature.

One hundred eleven patients with acute rupture of the Achilles tendon were included in a prospective trial and randomly assigned to groups for operative (56 patients) or nonoperative (55 patients) treatment. All of the patients were followed with clinic evaluations at 4 months and 1 year after the rupture. The major complications in the operative treatment group were three reruptures and two deep infections as compared with seven reruptures, one second rerupture, and one extreme residual lengthening of the tendon in the nonoperative group. There were fewer minor complications in the nonoperative group than in the operative group. The operatively treated patients had a significantly higher rate of resuming sports activities at the same level, a lesser degree of calf atrophy, better ankle movement, and fewer complaints 1 year after the accident. The conclusion we reached through this randomized prospective study is that operative treatment of ruptured Achilles tendons is preferable, but nonoperative treatment is an acceptable alternative.

Long-term follow-up of meniscectomy in athletes. A prospective longitudinal study.

We report the results of a prospective longitudinal study of 147 athletes who had had a meniscectomy for an isolated meniscus injury. The patients were reviewed in detail after median periods of 4.5 years and 14.5 years and the results analysed. The frequency of complaints related to the operation increased from 53% at 4.5 years to 67% at 14.5 years, while demonstrable knee instability increased from 10% to 36%. The incidence of radiographic changes of degeneration rose from 40% to 89% and at late review 8% of patients had definite osteoarthritis by the criteria of Ahlbäck (1968). In consequence 46% had given up or reduced their sporting activity, and 6.5% had changed their occupation. Radiographic deterioration started after the 4.5-year review in 49% of the patients and was more frequent after lateral than medial meniscectomy.

Arthroscopy of the proximal interphalangeal joints of the finger.

Cadaveric studies were carried out to evaluate the technique, portals and possible indications for arthroscopy of the proximal interphalangeal joints of the finger. We suggest horizontal placement of the hand instead of using a traction tower, as it is important to be able to flex the joint freely. The recommended arthroscopic portals are either between the central slip and the lateral bands of the extensor mechanism or between the lateral band and the collateral ligament. A blunt technique of introduction is used to avoid iatrogenic cartilage damage and possible digital nerve injury.

Hexcelite versus plaster of Paris: a controlled trial of the below-knee walking cast.

Hexcelite and plaster of Paris below-knee walking casts were compared in a controlled clinical trial, involving 82 patients. Fewer bandage complications, problems and better comfort was found with Hexcelite compared to plaster of Paris (P less than 0.05). If all costs relating to materials, transportation, complications and extra visits due to these, were taken into account, plaster of Paris was found more expensive than Hexcelite. Based on the above an increased use of Hexcelite is recommended.