Objective To investigate the characteristics of the anterior tibiotalar fat pad (ATFP) in the ank... more Objective To investigate the characteristics of the anterior tibiotalar fat pad (ATFP) in the ankle joint in a population of patients 1 year after an ankle sprain and its correlation with systemic factors and local articular pathology. Design The study is a secondary analysis of an observational case-control study. We included 206 patients who were followed 6-12 months after ankle sprain. T1 MRI scans were assessed for signal intensity and area of ATFP by mapping the fat pad using dedicated imaging software (Mimics 18.0). Quantitative values of intensity and area were generated. Linear regression analysis was used to examine the association between both local and systemic factors and the ATFP. Variables with a P value <0.2 were entered in 5 stepwise multivariate models: (1) age-sex-body mass index (BMI); (2) anamnesis; (3) physical examination; (4) radiographic findings; and (5) MRI findings. Predictors in these separate models were entered in the final model. Results The final m...
Does infrapatellar fat pad resection in total knee arthroplasty impair clinical outcome? A system... more Does infrapatellar fat pad resection in total knee arthroplasty impair clinical outcome? A systematic review
BackgroundOsteoarthritis is the most frequent chronic joint disease causing pain and disability. ... more BackgroundOsteoarthritis is the most frequent chronic joint disease causing pain and disability. Besides biomechanical mechanisms, the pathogenesis of osteoarthritis may involve inflammation, vascular alterations and dysregulation of lipid metabolism. As statins are able to modulate many of these processes, this study examines whether statin use is associated with a decreased incidence and/or progression of osteoarthritis.MethodsParticipants in a prospective population-based cohort study aged 55 years and older (n=2921) were included. x-Rays of the knee/hip were obtained at baseline and after on average 6.5 years, and scored using the Kellgren and Lawrence score for osteoarthritis. Any increase in score was defined as overall progression (incidence and progression). Data on covariables were collected at baseline. Information on statin use during follow-up was obtained from computerised pharmacy databases. The overall progression of osteoarthritis was compared between users and non-u...
Teaching point: Unexplained bone marrow edema on MRI warrants further investigation with CT to de... more Teaching point: Unexplained bone marrow edema on MRI warrants further investigation with CT to demonstrate a nidus which is pathognomonic for an osteoid osteoma.
We report a non-united tibial spine fracture with instability of the anterior cruciate ligament i... more We report a non-united tibial spine fracture with instability of the anterior cruciate ligament in a twenty-year-old soccer player. The patient underwent arthroscopy with debridement of scar tissue around the fracture site, reduction and fixation of the bony insertion of the ACL using screw and washer, and femoral notchplasty. More than one year after the initial surgery, the patient fully recovered knee stability and function. We have demonstrated that the additional problems caused by a non-union of a tibial spine fracture can be dealt with in one arthroscopic session.
Category: Hindfoot Introduction/Purpose: An adult acquired flat foot (AAFD) is a complex 3D defor... more Category: Hindfoot Introduction/Purpose: An adult acquired flat foot (AAFD) is a complex 3D deformity. A medializing calcaneal osteotomy (MCO) is a surgical procedure frequently performed to correct the valgus alignment of the hindfoot in a stage II AAFD, when conservative measurements fail. However currently little is known on its accurate influence regarding the hindfoot alignment (HA). The aim is therefore to assess the influence of a MCO on the 3D HA using computer aided software analysis of the images retrieved from a weightbearing cone beam CT (WBCT). Methods: Twelve patients with a mean age of 49,4 years (range 18-67yrs) were prospectively included in a pre-post study design. Indications for surgical correction by a MCO with a solitary translation consisted of an AAFD stage II (N=10) and a posttraumatic valgus deformity (N=2). Fixation of the osteotomy was performed by a step-plate or double screw. WBCT was obtained pre- and post-operative. Images were subsequently segmented ...
Objective Free fatty acids (FAs) may influence cartilage metabolism and osteoarthritis (OA) disea... more Objective Free fatty acids (FAs) may influence cartilage metabolism and osteoarthritis (OA) disease progression. It is not clearly studied which FAs are present in the synovial fluid of knee joints and whether there are differences in FA content between nonsymptomatic and OA knee joints. The aim of this study was to investigate the presence of different types of FAs in synovial fluid of both OA- and nonsymptomatic control joints, and to analyze differences between both groups. Design A total of 23 synovial fluid samples were collected from patients with end-stage knee OA undergoing total knee replacement, with approval of the medical ethical committee. As controls, 6 synovial fluid samples were obtained from postmortem donors without any history of joint disease or arthritis. Measurement of free FA concentration was done by mass spectrometry for saturated FAs (SFA), monounsaturated FAs (MUFA), and omega-3 and omega-6 polyunsaturated FAs (n-3 PUFAs and n-6 PUFAs). Results Our measure...
To determine the frequency of anterolateral ligament (ALL) injury in patients with acute anterior... more To determine the frequency of anterolateral ligament (ALL) injury in patients with acute anterior cruciate ligament (ACL) rupture and to analyse its associated injury patterns. Ninety patients with acute ACL rupture for which MRI was obtained within 8 weeks after the initial trauma were retrospectively identified. Two radiologists assessed the status of the ALL on MRI by consensus. The presence or absence of an ALL abnormality was compared with the existence of medial and lateral meniscal tears diagnosed during arthroscopy. Associated collateral ligament and osseous injuries were documented with MRI. Forty-one of 90 knees (46 %) demonstrated ALL abnormalities on MRI. Of 49 knees with intact ALL, 15 (31 %) had a torn lateral meniscus as compared to 25 torn lateral menisci in 41 knees (61 %) with abnormal ALL (p = 0.008). Collateral ligament (p ≤ 0.05) and osseous injuries (p = 0.0037) were more frequent and severe in ALL-injured as compared with ALL-intact knees. ALL injuries are fairly common in patients with acute ACL rupture and are statistically significantly associated with lateral meniscal, collateral ligament and osseous injuries. • ALL injuries are fairly common in patients with acute ACL rupture. • ALL injuries are highly associated with lateral meniscal and osseous injuries. • MRI assessment of ACL-injured knees should include evaluation of the ALL.
Objective To investigate the characteristics of the anterior tibiotalar fat pad (ATFP) in the ank... more Objective To investigate the characteristics of the anterior tibiotalar fat pad (ATFP) in the ankle joint in a population of patients 1 year after an ankle sprain and its correlation with systemic factors and local articular pathology. Design The study is a secondary analysis of an observational case-control study. We included 206 patients who were followed 6-12 months after ankle sprain. T1 MRI scans were assessed for signal intensity and area of ATFP by mapping the fat pad using dedicated imaging software (Mimics 18.0). Quantitative values of intensity and area were generated. Linear regression analysis was used to examine the association between both local and systemic factors and the ATFP. Variables with a P value <0.2 were entered in 5 stepwise multivariate models: (1) age-sex-body mass index (BMI); (2) anamnesis; (3) physical examination; (4) radiographic findings; and (5) MRI findings. Predictors in these separate models were entered in the final model. Results The final m...
Does infrapatellar fat pad resection in total knee arthroplasty impair clinical outcome? A system... more Does infrapatellar fat pad resection in total knee arthroplasty impair clinical outcome? A systematic review
BackgroundOsteoarthritis is the most frequent chronic joint disease causing pain and disability. ... more BackgroundOsteoarthritis is the most frequent chronic joint disease causing pain and disability. Besides biomechanical mechanisms, the pathogenesis of osteoarthritis may involve inflammation, vascular alterations and dysregulation of lipid metabolism. As statins are able to modulate many of these processes, this study examines whether statin use is associated with a decreased incidence and/or progression of osteoarthritis.MethodsParticipants in a prospective population-based cohort study aged 55 years and older (n=2921) were included. x-Rays of the knee/hip were obtained at baseline and after on average 6.5 years, and scored using the Kellgren and Lawrence score for osteoarthritis. Any increase in score was defined as overall progression (incidence and progression). Data on covariables were collected at baseline. Information on statin use during follow-up was obtained from computerised pharmacy databases. The overall progression of osteoarthritis was compared between users and non-u...
Teaching point: Unexplained bone marrow edema on MRI warrants further investigation with CT to de... more Teaching point: Unexplained bone marrow edema on MRI warrants further investigation with CT to demonstrate a nidus which is pathognomonic for an osteoid osteoma.
We report a non-united tibial spine fracture with instability of the anterior cruciate ligament i... more We report a non-united tibial spine fracture with instability of the anterior cruciate ligament in a twenty-year-old soccer player. The patient underwent arthroscopy with debridement of scar tissue around the fracture site, reduction and fixation of the bony insertion of the ACL using screw and washer, and femoral notchplasty. More than one year after the initial surgery, the patient fully recovered knee stability and function. We have demonstrated that the additional problems caused by a non-union of a tibial spine fracture can be dealt with in one arthroscopic session.
Category: Hindfoot Introduction/Purpose: An adult acquired flat foot (AAFD) is a complex 3D defor... more Category: Hindfoot Introduction/Purpose: An adult acquired flat foot (AAFD) is a complex 3D deformity. A medializing calcaneal osteotomy (MCO) is a surgical procedure frequently performed to correct the valgus alignment of the hindfoot in a stage II AAFD, when conservative measurements fail. However currently little is known on its accurate influence regarding the hindfoot alignment (HA). The aim is therefore to assess the influence of a MCO on the 3D HA using computer aided software analysis of the images retrieved from a weightbearing cone beam CT (WBCT). Methods: Twelve patients with a mean age of 49,4 years (range 18-67yrs) were prospectively included in a pre-post study design. Indications for surgical correction by a MCO with a solitary translation consisted of an AAFD stage II (N=10) and a posttraumatic valgus deformity (N=2). Fixation of the osteotomy was performed by a step-plate or double screw. WBCT was obtained pre- and post-operative. Images were subsequently segmented ...
Objective Free fatty acids (FAs) may influence cartilage metabolism and osteoarthritis (OA) disea... more Objective Free fatty acids (FAs) may influence cartilage metabolism and osteoarthritis (OA) disease progression. It is not clearly studied which FAs are present in the synovial fluid of knee joints and whether there are differences in FA content between nonsymptomatic and OA knee joints. The aim of this study was to investigate the presence of different types of FAs in synovial fluid of both OA- and nonsymptomatic control joints, and to analyze differences between both groups. Design A total of 23 synovial fluid samples were collected from patients with end-stage knee OA undergoing total knee replacement, with approval of the medical ethical committee. As controls, 6 synovial fluid samples were obtained from postmortem donors without any history of joint disease or arthritis. Measurement of free FA concentration was done by mass spectrometry for saturated FAs (SFA), monounsaturated FAs (MUFA), and omega-3 and omega-6 polyunsaturated FAs (n-3 PUFAs and n-6 PUFAs). Results Our measure...
To determine the frequency of anterolateral ligament (ALL) injury in patients with acute anterior... more To determine the frequency of anterolateral ligament (ALL) injury in patients with acute anterior cruciate ligament (ACL) rupture and to analyse its associated injury patterns. Ninety patients with acute ACL rupture for which MRI was obtained within 8 weeks after the initial trauma were retrospectively identified. Two radiologists assessed the status of the ALL on MRI by consensus. The presence or absence of an ALL abnormality was compared with the existence of medial and lateral meniscal tears diagnosed during arthroscopy. Associated collateral ligament and osseous injuries were documented with MRI. Forty-one of 90 knees (46 %) demonstrated ALL abnormalities on MRI. Of 49 knees with intact ALL, 15 (31 %) had a torn lateral meniscus as compared to 25 torn lateral menisci in 41 knees (61 %) with abnormal ALL (p = 0.008). Collateral ligament (p ≤ 0.05) and osseous injuries (p = 0.0037) were more frequent and severe in ALL-injured as compared with ALL-intact knees. ALL injuries are fairly common in patients with acute ACL rupture and are statistically significantly associated with lateral meniscal, collateral ligament and osseous injuries. • ALL injuries are fairly common in patients with acute ACL rupture. • ALL injuries are highly associated with lateral meniscal and osseous injuries. • MRI assessment of ACL-injured knees should include evaluation of the ALL.
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