The Ankle Ligament Reconstruction-Return to Sport after Injury (ALR-RSI) is a valid and reliable measure to assess psychological readiness before returning to sport following peroneal tendon pathology surgery.

PURPOSE: The objective of this study was to validate a scale that could help surgeons evaluate patients' psychological readiness to return to sport (RTS) after peroneal tendon pathology surgery. METHODS: The Ankle Ligament Reconstruction-Return to Sport after Injury (ALR-RSI) scale, which had previously been validated in ankle ligament reconstruction patients, was adapted to evaluate the psychological preparedness for RTS in athletic patients who underwent peroneal tendinopathy surgery. The Foot and Ankle Outcome Score (FAOS) and Foot Ankle Ability Measurement (FAAM) scores were employed as patient-related outcome measurement (PROM) instruments. RESULTS: This study included 57 patients. There was a strong correlation between ALR-RSI and both FAOS and FAAM (r = -0.68 and 0.74, respectively). ALR-RSI was considerably higher in patients who returned to sports than in those who did not. The mean score was 72.9 ± 19.0 in patients who returned to the same preinjury level, 48.5 ± 24.0 in those who returned to a lower level and 53.6 ± 31.1 in patients who changed their athletic activity (p < 0.0001). Furthermore, ALR-RSI showed at least a similar discrimination ability when compared to FAOS and FAAM. The test-retest intraclass correlation coefficient was 0.95. The Cronbach's α statistic used to measure the internal consistency was high (0.95). A Youden index of 0.65 was observed for a cut-off score of 68 points. CONCLUSION: ALR-RSI is a valid instrument for assessing psychological readiness to RTS in an athletic population following peroneal tendon surgery. When compared to the most commonly used PROMs, it was strongly correlated and demonstrated at least similar discrimination capacity. This could assist surgeons in identifying athletes who will have poor postoperative results and advising them on their capability to RTS. LEVEL OF EVIDENCE: Level III.

A Review of Chronic Lateral Ankle Instability and Emerging Alternative Outcome Monitoring Tools in Patients following Ankle Ligament Reconstruction Surgery.

Ankle sprains are exceedingly common injuries in both athletes and the general population. They account for 10 to 30% of all sports injuries. Although the vast majority of lateral ankle ligament injuries respond successfully to conservative management, the absolute number of those that progress to chronic lateral ankle instability (CLAI) remains considerably important. This condition is characterized by persistent symptoms and may be associated with short-term and long-term complications and functional deficits. There is still a lack of ideal postoperative management of CLAI patients. Furthermore, an evidence-based rehabilitation phasing does not exist and most of the published studies regarding this subject suggest some protocols based on a wide variety of functional assessment scores and other modalities that are not accurate enough. Moreover, the literature that assesses the ability to return to work (RTW) and return to sport (RTS) in the general population and athletes operated for CLAI most commonly shows aggregated results with global rates of RTW or RTS without describing a detailed timeline based on the readiness of patients to return to each level of activity. Although stress radiographs and MRI have been assessed as potential tools to improve postoperative management of CLAI patients, the first modality is limited by its low sensitivity to detect laxity and the second one by its static character and its inability to predict neither the healing process phase nor the mechanical properties of the repaired/reconstructed ligaments. Bioelectrical impedance, mechanical impedance and near-infrared spectroscopy are non-invasive methods of measurement that could be potential assessment tools to help surgeons improve the postoperative management of patients after CLAI surgery.

Validation of the Ankle Ligament Reconstruction-Return to Sports after Injury (ALR-RSI) Score as a Tool to Assess Psychological Readiness to Return to Sport in an Active Population After Ankle Fracture Surgery: A Cross-sectional Study.

Ankle injuries account for 15% to 25% of all sports injuries resulting in significant pain and loss of function. The purpose of this cross-sectional study was to validate a scale to help surgeons quantify the psychological readiness to Return To Sport (RTS) in patients undergoing ankle fracture surgery. ALR-RSI was used to assess the psychological readiness for RTS in athletic patients who underwent ankle fracture fixation between January 2020 and January 2021. Participants filled out ALR-RSI and 2 Patient-Related Outcome Measurement (PROM) tools: Olerud-Molander Ankle Score (OMAS) and Self-Reported Foot and Ankle Score (SEFAS). A total of 93 patients were included. There was a strong correlation between ALR-RSI and both OMAS and SEFAS, with Pearson coefficients of r = 0.58 and 0.53, respectively. ALR-RSI was significantly higher in the RTS group than in those who no longer practiced their main preinjury sport. Moreover, the discriminant validity of ALR-RSI (AUC = 0.81) was better than that of the SEFAS and OMAS (AUC = 0.64 and 0.65, respectively, p = .001). The intra-class correlation coefficient ρ of 0.94 showed excellent reproducibility. At an optimal cutoff value of 76.7, ALR-RSI had a sensitivity of 81% and a specificity of 75% with a Youden index of 0.56. In conclusion, ALR-RSI was a valid and reproducible tool to evaluate the psychological readiness for RTS in an active population after an ankle fracture. This score could help surgeons identify athletes who may have unfavorable postoperative outcomes and provide support on the ability to RTS.

Intraoperative Optical Monitoring of Spinal Cord Hemodynamics Using Multiwavelength Imaging System.

The spinal cord is a major structure of the central nervous system allowing, among other things, the transmission of afferent sensory and efferent motor information. During spinal surgery, such as scoliosis correction, this structure can be damaged, resulting in major neurological damage to the patient. To date, there is no direct way to monitor the oxygenation of the spinal cord intraoperatively to reflect its vitality. This is essential information that would allow surgeons to adapt their procedure in case of ischemic suffering of the spinal cord. We report the development of a specific device to monitor the functional status of biological tissues with high resolution. The device, operating with multiple wavelengths, uses Near-InfraRed Spectroscopy (NIRS) in combination with other additional sensors, including ElectroNeuroGraphy (ENG). In this paper, we focused primarily on aspects of the PhotoPlethysmoGram (PPG), emanating from four different light sources to show in real time and record biological signals from the spinal cord in transmission and reflection modes. This multispectral system was successfully tested in in vivo experiments on the spinal cord of a pig for specific medical applications.

Source-Detector Spectral Pairing-Related Inaccuracies in Pulse Oximetry: Evaluation of the Wavelength Shift.

Pulse oximetry enables oxygen saturation estimation ( S p O 2) non-invasively in real time with few components and modest processing power. With the advent of affordable development kits dedicated to the monitoring of biosignals, capabilities once reserved to hospitals and high-end research laboratories are becoming accessible for rapid prototyping. While one may think that medical-grade equipment differs greatly in quality, surprisingly, we found that the performance requirements are not widely different from available consumer-grade components, especially regarding the photodetection module in pulse oximetry. This study investigates how the use of candidate light sources and photodetectors for the development of a custom S p O 2 monitoring system can lead to inaccuracies when using the standard computational model for oxygen saturation without calibration. Following the optical characterization of selected light sources, we compare the extracted parameters to the key features in their respective datasheet. We then quantify the wavelength shift caused by spectral pairing of light sources in association with photodetectors. Finally, using the widely used approximation, we report the resulting absolute error in S p O 2 estimation and show that it can lead up to 8% of the critical 90-100% saturation window.

In vivo NIRS monitoring in pig Spinal Cord tissues.

Little is known about the processes occurring after Spinal Cord damage. Whether permanent or recoverable, those processes have not been precisely characterized because their mechanism is complex and information on the functioning of this organ are partial. This study demonstrates the feasibility of Spinal Cord activity monitoring using Near Infra-Red Spectroscopy in a pig animal model. This animal has been chosen because of its comparable size and its similarities with humans. In the first step, optical characterization of the Spinal Cord tissues was performed in different conditions using a spectrophotometer. Optical Density was evaluated between 3.5 and 6.5 in the [500; 950] nm range. Secondly, adapted light sources with custom probes were used to observe autonomic functions in the spine. Results on the measured haemodynamics at rest and under stimulation show in real time the impact of a global stimulus on a local section of the Spinal Cord. The photoplethysmogram signal of the Spinal Cord showed low AC-to-DC ratio (below to 1 %).

A Review of the CMOS Buried Double Junction (BDJ) Photodetector and its Applications.

A CMOS Buried Double Junction PN (BDJ) photodetector consists of two vertically-stacked photodiodes. It can be operated as a photodiode with improved performance and wavelength-sensitive response. This paper presents a review of this device and its applications. The CMOS implementation and operating principle are firstly described. This includes the description of several key aspects directly related to the device performances, such as surface reflection, photon absorption and electron-hole pair generation, photocurrent and dark current generation, etc. SPICE modelling of the detector is then presented. Next, design and process considerations are proposed in order to improve the BDJ performance. Finally, several BDJ-detector-based image sensors provide a survey of their applications.