Dutch Translation and Cross-cultural Adaptation of the Lysholm Score and Tegner Activity Scale for Patients With Anterior Cruciate Ligament Injuries.

Study Design Clinical measurement. Background The Lysholm score and Tegner activity scale are frequently used patient-reported instruments to determine the functional status and activity level after anterior cruciate ligament (ACL) reconstruction. Objectives To translate and cross-culturally adapt the Lysholm score and Tegner activity scale for use in the Dutch population and to evaluate the reliability and validity of these questionnaires in individuals after ACL reconstruction. Methods The translation and adaptation were conducted in several steps according to the guidelines in the literature. The measurement properties of the Lysholm score and Tegner activity scale (internal consistency, construct validity, and floor and ceiling effects) were tested in 96 patients. Reproducibility was tested in 69 patients with ACL injuries. On the first occasion, the International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC) and RAND 36-Item Health Survey (RAND-36) were also administered. Results The Lysholm score and Tegner activity scale showed good test-retest reliability between repeated measures (intraclass correlation coefficient = 0.93 and 0.97, respectively) and reasonable to good internal consistency (Cronbach α = .70-.83). The Lysholm score had a very strong correlation with the IKDC (r = 0.83, P<.01) and moderate correlation with the RAND-36 (r = 0.55, P<.01). The Tegner activity scale had moderate correlations with both the IKDC (r = 0.42, P<.01) and RAND-36 (r = 0.48, P<.01). Conclusion The psychometric performance of the Lysholm score and the Tegner activity scale as outcome measures for Dutch patients after ACL reconstruction is acceptable. J Orthop Sports Phys Ther 2016;46(11):976-983. Epub 28 Sep 2016. doi:10.2519/jospt.2016.6566.

An uncemented iso-elastic monoblock acetabular component: preliminary results.

Little is known about the clinical application of highly cross-linked polyethylene (HXLPE) blended with vitamin E. This study evaluates an uncemented iso-elastic monoblock cup with vitamin E blended HXLPE. 112 patients were followed up for 2years. 95.5% completed the follow-up. The mean VAS score for patient satisfaction was 8.8 and the mean Harris Hip Score was 94.2. In 7 cases initial gaps behind the cup were observed, which disappeared completely during follow-up in 6 cases. The mean femoral head penetration rate was 0.055mm/year. No adverse reactions or abnormal mechanical behavior was observed with the short term use of vitamin E blended HXLPE. This study shows the promising performance of this cup and confirms the potential of vitamin E blended HXLPE.

Excellent survivorship of the Morscher monoblock cup with a 28-mm Metasul-on-Metasul bearing at a mean of 5-year follow-up.

The Morscher monoblock cup is designed for optimal osteointegration and holds the potential for excellent long-term survival. The Metasul-on-Metasul bearing was introduced to eliminate wear-induced periprosthetic osteolysis. This study reviews 137 Morscher cups with a 28-mm Metasul-on-Metasul bearing used in primary THA at 5.1years (3.2-6.6) after implantation. One hundred thirty-seven cups were implanted in 119 patients. Three patients (2.2%) had died of unrelated causes, and 10 patients (8.0%) were lost to follow-up. The mean Harris Hip score was 89.8 and the mean WOMAC sum score was 18.5. No cases of acetabular osteolysis were found. The 5-year cup survival rate was 98.5%. The Morscher cup with a 28-mm Metasul-on-Metasul bearing used in uncemented THA showed no acetabular osteolysis and promising survivorship at intermediate-term follow-up.

The ICI classification for calcaneal injuries: a validation study.

INTRODUCTION: The integral classification of injuries (ICI), by Zwipp et al. has been developed as a classification system for injuries of the bones, joints, cartilage and ligaments of the foot. It follows the principles of the comprehensive classification of fractures by Müller et al. The ICI was developed for 'everyday use' and scientific purposes. Our aim was to perform a validation study for this classification system applied to the calcaneal injuries. METHODS: A panel of five experienced trauma and orthopaedic surgeons evaluated the ICI score in 20 calcaneal injuries. After 2 months, a second classification was performed in a different order. Inter- and intra-observer variability were evaluated by kappa statistics. RESULTS: Panel members were not able to evaluate capsule and ligamental injuries based on X-ray and computed tomography (CT) films. Two injuries were excluded for logistical reasons. The inter-observer agreement based on 18 injuries of bone and joints was slight; kappa 0.14 (90% confidence interval (CI): 0.05-0.22). The intra-observer agreement was fair; kappa 0.31 (90% CI: 0.22-0.41). Overall, the panel rated the system as very complicated and not practical. CONCLUSION: The ICI is a complicated classification system with slight to fair inter- and intra-observer variabilities. It might not be a practical classification system for calcaneal injuries in 'everyday use' or scientific purposes.

Role of the long head of the biceps brachii muscle in axial humeral rotation control.

This anatomical and biomechanical study focuses on the specific influence of the long head of biceps brachii muscle in controlling axial humeral rotation. The tendon of the long head of the biceps brachii (biceps tendon) is shown to either facilitate or restrict axial humeral rotation. Its effect on axial humeral rotation is strongly related to firstly the amount of biceps tendon load, secondly glenohumeral scapular plane elevation, and thirdly the rotatory position of the humerus. At 0° glenohumeral elevation, biceps tendon load caused an increase of internal humeral rotation, from 0° at 2.25 N biceps tendon load to 23° at 82.25 N. Under 45° glenohumeral elevation, biceps tendon load can restrict and facilitate as well internal and external axial humeral rotation, increasing the rotatory range of motion. Above 45° glenohumeral elevation biceps tendon load restricts internal and external axial humeral rotation, increasing actively joint stability by increasing torsional rigidity. These findings on the function of the biceps tendon could have consequences for the clinical interpretation. In the elevated arm position, extreme rotation loads the long head of the biceps tendon and may turn out to biceps or bicepslabrum complex injuries.

[Scientific output of orthopaedic hospitals in the Netherlands: not all hospitals meet the requirements of the Dutch orthopaedic residency programme]. / Wetenschappelijke productie van orthopedische opleidingsklinieken: niet alle klinieken voldoen aan richtlijn in Opleidingsplan Orthopedie.

OBJECTIVE: To evaluate the feasibility of the requirements for scientific participation in the Dutch orthopaedic residency programme by assessing the numbers of articles published by orthopaedic teaching hospitals. DESIGN: Descriptive. METHOD: All 29 orthopaedic teaching hospitals in the Netherlands were asked to draw up a list of articles published from 2004 to 2009. The publications were subdivided into papers indexed in PubMed and papers published in the Nederlands Tijdschrift voor Orthopedie (NTvO, Netherlands Journal of Orthopaedics) and the Nederlands Tijdschrift voor Traumatologie (NTvT, Netherlands Journal of Traumatology). RESULTS: There was an overall response rate of 72% (21/29). For the 8 non-responders a search of PubMed and the NTvO-NTvT journal databases was used to compile a list of their publications. The university teaching hospitals (n = 8) published 1150 articles, 1118 of which were indexed in PubMed, 19 published in the NTvO and 13 in the NTvT. Peripheral teaching hospitals (n = 21) published 689 articles: 590 indexed in PubMed, 77 published in the NTvO and 22 in the NTvT. In the peripheral teaching hospitals there was a positive correlation between the number of orthopaedic surgeons and PhD students and the number of published articles. CONCLUSION: Of the 29 teaching hospitals, 9 (31%) did not meet the requirements for publication specified in the Dutch orthopaedic residency programme guidelines. The number of published articles is related to the numbers of orthopaedic surgeons and PhD students in peripheral teaching hospitals. The requirements for the minimum number of publications could therefore be revised to reflect the proportion of orthopaedic surgeons in each teaching hospital. The introduction of a weighting factor that accounts for the quality of the publications would also result in a more balanced assessment.