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1. The Popeye sign:a doctor's and not a patient's problem

Author

Ronald N. Wessel, Michel P.J. van den Bekerom, Marieke F. van Wier, Derek F.P. van Deurzen, Frans L. Garssen, Gino M. M. J. Kerkhoffs, Orthopedic Surgery and Sports Medicine, Otolaryngology / Head & Neck Surgery, APH - Quality of Care, AMS - Ageing & Vitality, and AMS - Sports

Subjects
Male, Shoulder, medicine.medical_specialty, Popeye, Diagnostic Study, Tenodesis, Popeye sign, Level III, 03 medical and health sciences, 0302 clinical medicine, Forelimb, medicine, Animals, Humans, Orthopedics and Sports Medicine, In patient, Muscle, Skeletal, long head of the biceps, 030222 orthopedics, reliability, business.industry, General surgery, Mean age, 030229 sport sciences, General Medicine, Middle Aged, Interobserver Agreement Design, Arm, Surgery, Female, business, Body mass index
Abstract

Background The Popeye sign is a frequently reported finding following long head of the biceps (LHB) surgery and may be more often detected by doctors than by patients. This study investigates agreement between patients and doctors regarding the presence of a Popeye sign following LHB surgery. Method This interobserver study investigates agreement between patients and consulting physicians with regard to assessment of a Popeye sign in patients following LHB surgery. Furthermore, this was compared with assessments by non–consulting physicians (observers) using digital photographs of the operated arm, taken both preoperatively and postoperatively. Data about gender, age, and body mass index (BMI) were collected to investigate their role in doctor’s reporting of a Popeye sign. Patient’s dissatisfaction with a Popeye sign in the operated arm was evaluated as well. Results Ninety-seven patients (mean age 61 ± 6.0 years, 62% male) underwent LHB surgery. A Popeye sign was reported by 2 patients (2%) as opposed to 32 cases (40%) by consulting physicians, of which only 1 case was in agreement. Krippendorff’s alpha (Kalpha) for agreement between observers for preoperative photographs was 0.074 (95% CI −0.277, 0.382) and 0.495 (95% CI 0.317, 0.659) for postoperative cases. Kalpha between observers and consulting physicians for pre- and postoperative cases were 0.033 (95% CI −970, 0.642) and 0.499 (95% CI 0.265, 0.699), respectively. Phi coefficient analysis showed a moderate, statistically significant correlation between male sex and Popeye sign identification. Rank-biserial calculation revealed negligible correlation between BMI and age with regard to detecting a Popeye sign by both consulting physicians and observers. Dissatisfaction about swelling in the upper arm was reported in 1 case, though in a location that did not correspond to the location of a Popeye sign. Conclusion The Popeye sign is more often identified by doctors than by patients after undergoing LHB surgery. BMI and age are not related to the detection of a Popeye sign, but sex is moderately correlated. Together with the low percentage of dissatisfaction of patients with this swelling, this signifies that a Popeye sign seems to be a doctor’s rather than a patient’s problem.

Published
2021

2. The normative Western Ontario Rotator Cuff Index values for age and sex

Author

Julie R.A. Massier, Ronald N. Wessel, and Nienke Wolterbeek

Subjects
Male, medicine.medical_specialty, Age and sex, Standard deviation, Rotator Cuff Injuries, 03 medical and health sciences, Rotator Cuff, 0302 clinical medicine, Shoulder pathology, Surveys and Questionnaires, medicine, Humans, Orthopedics and Sports Medicine, Rotator cuff, Prospective Studies, Prospective cohort study, Ontario, 030222 orthopedics, business.industry, Rotator cuff injury, 030229 sport sciences, General Medicine, medicine.disease, Shoulder disease, medicine.anatomical_structure, Physical therapy, Normative, Surgery, Female, business
Abstract

Background The Western Ontario Rotator Cuff Index (WORC) is a widely used disease-specific outcome tool developed for patients with rotator cuff injuries. The determination of age- and sex-adjusted normative WORC values enables us to determine whether a procedure is more beneficial in specific patient groups because the results can be compared with a matched standard. The purpose of this study was to determine normative WORC values and assess whether the WORC needs an adjusted score for age and sex. Methods We included participants using an online data-capturing program. We collected the following variables: age, sex, presence of shoulder pathology, Subjective Shoulder Value, and WORC score. We defined the mean normative WORC score per age category and analyzed sex differences in WORC scores per age category and in all domains of the WORC score. Results A total of 470 participants filled out the questionnaire. We excluded 44 participants because of pre-existing shoulder complaints or incomplete questionnaires. The mean total WORC score was 94% (standard deviation, 9%), and the mean total WORC score in every age and sex category was >90%. Of all participants, 85% scored between 91% and 100%; 63 participants (15%) scored 100%. The mean overall Subjective Shoulder Value was 98% (standard deviation, 6%). We found no statistically significant differences between sexes in the overall score, in the domain scores, and within the age categories. Conclusion We defined normative values for the WORC questionnaire in a random prospective cohort and found no difference in scores between sexes. The mean normative scores all were within the variance of the maximum, and the WORC score did not deteriorate with age. It seems that the results of this subjective questionnaire change with the participant's perspective. An adjusted WORC score for age and sex is not necessary. This information can serve as a basis for comparison with patients with shoulder disease.

Published
2020

3. Response shift of the Western Ontario Rotator Cuff index in patients undergoing arthroscopic rotator cuff repair

Author

Ronald N. Wessel, Nienke Wolterbeek, and Freek Hollman

Subjects
Male, medicine.medical_specialty, Rotator Cuff Injuries, Arthroscopy, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Surveys and Questionnaires, Humans, Medicine, Orthopedics and Sports Medicine, In patient, Rotator cuff, Prospective Studies, 030212 general & internal medicine, business.industry, General Medicine, Middle Aged, Surgery, medicine.anatomical_structure, Patient Satisfaction, Quality of Life, Physical therapy, Female, business, 030217 neurology & neurosurgery
Abstract

Hypothesis This study determined the response shift in patients undergoing rotator cuff repair using the Western Ontario Rotator Cuff index (WORC), a disease-specific quality of life questionnaire. We hypothesized there would be a response shift with a positive recalibration (overestimated their preoperative disability) on the WORC and increases over time. Methods The study prospectively included 36 patients undergoing arthroscopic rotator cuff repair. At baseline, 3 months (T1), and 1 year (T2) after surgery the WORC, EuroQol (EQ)-5D-3L, and the patient's level of satisfaction after surgery were scored. To evaluate the response shift, patients also completed the WORC at 3 months (Pre-T1) and 1 year (Pre-T2) as how they perceived themselves to have been before surgery. Results The result on Pre-T1 and Pre-T2 results revealed that patients retrospectively rated their overall WORC score comparable with the baseline WORC score (Pre-T0; T0 = 40.5 ± 18.4, Pre-T1 = 45.0 ± 22.7, Pre-T2 = 34.3 ± 21.3). No response shift was observed on all domains except a negative recalibrated response shift for emotional disability on T1 ( P = .04). Conclusions No significant group-level response shift was observed using the WORC, except for the subdomain emotional disability at 3 months after arthroscopic rotator cuff repair. With the absence of any shift in patient's perception on the self-administered quality of life–related WORC questionnaire, this study suggests one could retrospectively reliably conduct group-level preoperative baseline information on quality of life up to 1 year after surgery.

Published
2016

4. Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial

Author

Aaron Nauth, Aaron T. Creek, Abby Zellar, Abdel-Rahman Lawendy, Adam Dowrick, Ajay Gupta, Akhil Dadi, Albert van Kampen, Albert Yee, Alexander C. de Vries, Alexander de Mol van Otterloo, Alisha Garibaldi, Allen Liew, Allison W. McIntyre, Amal Shankar Prasad, Amanda W. Romero, Amar Rangan, Amber Oatt, Amir Sanghavi, Amy L. Foley, Anders Karlsten, Andrea Dolenc, Andrew Bucknill, Andrew Chia, Andrew Evans, Andrew Gong, Andrew H. Schmidt, Andrew J. Marcantonio, Andrew Jennings, Angela Ward, Angshuman Khanna, Anil Rai, Anke B. Smits, Annamarie D. Horan, Anne Christine Brekke, Annette Flynn, Aravin Duraikannan, Are Stødle, Arie B. van Vugt, Arlene Luther, Arthur W. Zurcher, Arvind Jain, Asgeir Amundsen, Ash Moaveni, Ashley Carr, Ateet Sharma, Austin D. Hill, Axel Trommer, B. Sachidananda Rai, Barbara Hileman, Bart Schreurs, Bart Verhoeven, Benjamin B. Barden, Bernhard Flatøy, Berry I. Cleffken, Berthe Bøe, Bertrand Perey, Birgit C. Hanusch, Brad Weening, Bram Fioole, Bram Rijbroek, Brett D. Crist, Brett Halliday, Brett Peterson, Brian Mullis, C. Glen Richardson, Callum Clark, Carlos A. Sagebien, Carmen C. van der Pol, Carol Bowler, Catherine A. Humphrey, Catherine Coady, Cees L. Koppert, Chad Coles, Chadi Tannoury, Charles J. DePaolo, Chris Gayton, Chris Herriott, Christina Reeves, Christina Tieszer, Christine Dobb, Christopher G. Anderson, Claire Sage, Claudine Cuento, Clifford B. Jones, Coks H.R. Bosman, Colleen Linehan, Cor P. van der Hart, Corey Henderson, Courtland G. Lewis, Craig A. Davis, Craig Donohue, Cyril Mauffrey, D.C. Sundaresh, Dana J. Farrell, Daniel B. Whelan, Daniel Horwitz, Daniel Stinner, Darius Viskontas, Darren M. Roffey, David Alexander, David E. Karges, David Hak, David Johnston, David Love, David M. Wright, David P. Zamorano, David R. Goetz, David Sanders, David Stephen, David Yen, Davide Bardana, Davy J Olakkengil, Deanna Lawson, Deborah Maddock, Debra L. Sietsema, Deeba Pourmand, Dennis Den Hartog, Derek Donegan, Diane Heels-Ansdell, Diane Nam, Dominic Inman, Dory Boyer, Doug Li, Douglas Gibula, Dustin M. Price, Dylan J. Watson, E. Mark Hammerberg, Edward T.C.H. Tan, Eelco J.R. de Graaf, Elise Berg Vesterhus, Elizabeth Roper, Elton Edwards, Emil H. Schemitsch, Eric R. Hammacher, Eric R. Henderson, Erica Whatley, Erick T. Torres, Erik G.J. Vermeulen, Erin Finn, Esther M.M. Van Lieshout, Eugene K. Wai, Evan R. Bannister, Evelyn Kile, Evert B.M. Theunissen, Ewan D. Ritchie, Farah Khan, Farhad Moola, Fiona Howells, Frank de Nies, Frank H.W.M. van der Heijden, Frank R.A.J. de Meulemeester, Frede Frihagen, Fredrik Nilsen, G. Ben Schmidt, G.H. Robert Albers, Garland K. Gudger, Garth Johnson, Gary Gruen, Gary Zohman, Gaurav Sharma, Gavin Wood, Geert W.M. Tetteroo, Geir Hjorthaug, Geir Jomaas, Geoff Donald, Geoffrey Ryan Rieser, Gerald Reardon, Gerard P. Slobogean, Gert R Roukema, Gijs A. Visser, Gilbert Moatshe, Gillian Horner, Glynis Rose, Gordon Guyatt, Graham Chuter, Greg Etherington, Gregory J. Della Rocca, Guri Ekås, Gwendolyn Dobbin, H. Michael Lemke, Hamish Curry, Han Boxma, Hannah Gissel, Hans Kreder, Hans Kuiken, Hans L.F. Brom, Hans-Christoph Pape, Harm M van der Vis, Harvinder Bedi, Heather A. Vallier, Heather Brien, Heather Silva, Heike Newman, Helena Viveiros, Henk van der Hoeven, Henry Ahn, Herman Johal, Herman Rijna, Heyn Stockmann, Hong A. Josaputra, Hope Carlisle, Igor van der Brand, Imro Dawson, Ivan Tarkin, Ivan Wong, J. Andrew Parr, J. Andrew Trenholm, J. Carel Goslings, J. David Amirault, J. Scott Broderick, Jaap P. Snellen, Jacco A.C. Zijl, Jaimo Ahn, James Ficke, James Irrgang, James Powell, James R. Ringler, James Shaer, James T. Monica, Jan Biert, Jan Bosma, Jan Egil Brattgjerd, Jan Paul M. Frölke, Jan Wille, Janakiraman Rajakumar, Jane E. Walker, Janell K. Baker, Janos P. Ertl, Jean Paul P.M. de Vries, Jean W.M. Gardeniers, Jedediah May, Jeff Yach, Jennifer T. Hidy, Jerald R. Westberg, Jeremy A. Hall, Jeroen van Mulken, Jessica Cooper McBeth, Jochem Hoogendoorn, Jodi M. Hoffman, Joe Joseph Cherian, John A. Tanksley, John Clarke-Jenssen, John D. Adams, John Esterhai, John F. Tilzey, John Murnaghan, John P. Ketz, John S. Garfi, John Schwappach, John T. Gorczyca, John Wyrick, Jonas Rydinge, Jonathan L. Foret, Jonathan M. Gross, Jonathan P. Keeve, Joost Meijer, Joris J.G. Scheepers, Joseph Baele, Joseph O'Neil, Joseph R. Cass, Joseph R. Hsu, Jules Dumais, Julia Lee, Julie A. Switzer, Julie Agel, Justin E. Richards, Justin W. Langan, Kahn Turckan, Kaili Pecorella, Kamal Rai, Kamran Aurang, Karl Shively, Karlijn van Wessem, Karyn Moon, Kate Eke, Katie Erwin, Katrine Milner, Kees Jan Ponsen, Kelli Mills, Kelly Apostle, Kelly Johnston, Kelly Trask, Kent Strohecker, Kenya Stringfellow, Kevin K. Kruse, Kevin Tetsworth, Khalis Mitchell, Kieran Browner, Kim Hemlock, Kimberly Carcary, Knut Jørgen Haug, Krista Noble, Kristin Robbins, Krystal Payton, Kyle J. Jeray, L. Joseph Rubino, Lauren A. Nastoff, Lauren C. Leffler, Laurents P.S. Stassen, Lawrence K. O'Malley, Lawrence M. Specht, Lehana Thabane, Leo M.G. Geeraedts, Leslie E. Shell, Linda K. Anderson, Linda S. Eickhoff, Lindsey Lyle, Lindsey Pilling, Lisa Buckingham, Lisa K. Cannada, Lisa M. Wild, Liz Dulaney-Cripe, Lodewijk M.S.J. Poelhekke, Lonneke Govaert, Lu Ton, Lucksy Kottam, Luke P.H. Leenen, Lydia Clipper, Lyle T. Jackson, Lynne Hampton, Maarten C. de Waal Malefijt, Maarten P. Simons, Maarten van der Elst, Maarten W.G.A. Bronkhorst, Mahesh Bhatia, Marc Swiontkowski, Margaret J. Lobo, Marilyn Swinton, Marinis Pirpiris, Marius Molund, Mark Gichuru, Mark Glazebrook, Mark Harrison, Mark Jenkins, Mark MacLeod, Mark R. de Vries, Mark S. Butler, Markku Nousiainen, Martijne van 't Riet, Martin C. Tynan, Martin Campo, Martin G. Eversdijk, Martin J. Heetveld, Martin Richardson, Mary Breslin, Mary Fan, Matt Edison, Matthew Napierala, Matthias Knobe, Matthias Russ, Mauri Zomar, Maurits de Brauw, Max Esser, Meghan Hurley, Melissa E. Peters, Melissa Lorenzo, Mengnai Li, Michael Archdeacon, Michael Biddulph, Michael Charlton, Michael D. McDonald, Michael D. McKee, Michael Dunbar, Michael E. Torchia, Michael Gross, Michael Hewitt, Michael Holt, Michael J. Prayson, Michael J.R. Edwards, Michael L. Beckish, Michael L. Brennan, Michael P. Dohm, Michael S.H. Kain, Michelle Vogt, Michelle Yu, Michiel H.J. Verhofstad, Michiel J.M. Segers, Michiel P.C. Siroen, Mike Reed, Milena R. Vicente, Milko M.M. Bruijninckx, Mittal Trivedi, Mohit Bhandari, Molly M. Moore, Monica Kunz, Morten Smedsrud, Naveen Palla, Neeraj Jain, Nico J.M. Out, Nicole Simunovic, Niels W.L. Schep, Oliver Müller, Onno R. Guicherit, Oscar J.F. Van Waes, Otis Wang, Pascal G. Doornebosch, Patricia Seuffert, Patrick J. Hesketh, Patrick Weinrauch, Paul Duffy, Paul Keller, Paul M. Lafferty, Paul Pincus, Paul Tornetta, Paul Zalzal, Paula McKay, Peter A. Cole, Peter D. de Rooij, Peter Hull, Peter M.N.Y.M. Go, Peter Patka, Peter Siska, Peter Weingarten, Philip Kregor, Philip Stahel, Philip Stull, Philippe Wittich, Piet A.R. de Rijcke, Pim Oprel, PJ Devereaux, Qi Zhou, R. Lee Murphy, Rachel Alosky, Rachel Clarkson, Raely Moon, Rajanikanth Logishetty, Rajesh Nanda, Raymond J. Sullivan, Rebecca G. Snider, Richard E. Buckley, Richard Iorio, Richard J Farrugia, Richard Jenkinson, Richard Laughlin, Richard P.R. Groenendijk, Richard W. Gurich, Ripley Worman, Rob Silvis, Robert Haverlag, Robert J. Teasdall, Robert Korley, Robert McCormack, Robert Probe, Robert V. Cantu, Roger B. Huff, Rogier K.J. Simmermacher, Rolf Peters, Roman Pfeifer, Ronald Liem, Ronald N. Wessel, Ronald Verhagen, Ronald Vuylsteke, Ross Leighton, Ross McKercher, Rudolf W. Poolman, Russell Miller, Ryan Bicknell, Ryan Finnan, Ryan M. Khan, Samir Mehta, Sandy Vang, Sanjay Singh, Sanjeev Anand, Sarah A. Anderson, Sarah A. Dawson, Scott B. Marston, Scott E. Porter, Scott T. Watson, Sebastiaan Festen, Shane Lieberman, Shannon Puloski, Shea A. Bielby, Sheila Sprague, Shelley Hess, Shelley MacDonald, Simone Evans, Sofia Bzovsky, Sondre Hasselund, Sophie Lewis, Stein Ugland, Stephanie Caminiti, Stephanie L. Tanner, Stephanie M. Zielinski, Stephanie Shepard, Stephen A. Sems, Stephen D. Walter, Stephen Doig, Stephen H. Finley, Stephen Kates, Stephen Lindenbaum, Stephen P. Kingwell, Steve Csongvay, Steve Papp, Steven E. Buijk, Steven J. Rhemrev, Steven M. Hollenbeck, Steven M. van Gaalen, Steven Yang, Stuart Weinerman, null Subash, Sue Lambert, Susan Liew, Sven A.G. Meylaerts, Taco J. Blokhuis, Tammo S. de Vries Reilingh, Tarjei Lona, Taryn Scott, Teresa K. Swenson, Terrence J. Endres, Terry Axelrod, Teun van Egmond, Thomas B. Pace, Thomas Kibsgård, Thomas M. Schaller, Thuan V. Ly, Timothy J. Miller, Timothy Weber, Toan Le, Todd M. Oliver, Tom M. Karsten, Tor Borch, Tor Magne Hoseth, Tor Nicolaisen, Torben Ianssen, Tori Rutherford, Tracy Nanney, Trevor Gervais, Trevor Stone, Tyson Schrickel, Tyson Scrabeck, Utsav Ganguly, V. Naumetz, Valda Frizzell, Veronica Wadey, Vicki Jones, Victoria Avram, Vimlesh Mishra, Vineet Yadav, Vinod Arora, Vivek Tyagi, Vivian Borsella, W. Jaap Willems, W.H. Hoffman, Wade T. Gofton, Wesley G. Lackey, Wesley Ghent, William Obremskey, William Oxner, William W. Cross, Yvonne M. Murtha, Zoe Murdoch, and Surgery

Subjects
Male, Bone Screws, Avascular necrosis, Kaplan-Meier Estimate, law.invention, Fracture Fixation, Internal, 0302 clinical medicine, Randomized controlled trial, Femur Head Necrosis, law, Fracture Fixation, Fracture fixation, Medicine and Health Sciences, 80 and over, Single-Blind Method, 030212 general & internal medicine, Non-U.S. Gov't, Aged, 80 and over, Fracture Healing, 030222 orthopedics, Hip fracture, Research Support, Non-U.S. Gov't, Hazard ratio, General Medicine, Equipment Design, Femur Head Necrosis/etiology, 3. Good health, Pulmonary embolism, Multicenter Study, Treatment Outcome, Randomized Controlled Trial, Fracture Fixation, Internal/adverse effects, Female, Reoperation, musculoskeletal diseases, medicine.medical_specialty, Femoral Neck Fractures/surgery, Internal/adverse effects, Bone healing, Research Support, N.I.H, 03 medical and health sciences, Research Support, N.I.H., Extramural, medicine, Journal Article, Humans, Adverse effect, Aged, business.industry, Extramural, medicine.disease, Femoral Neck Fractures, Surgery, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Reoperation/statistics & numerical data, Quality of Life, business
Abstract

© 2017 Elsevier Ltd Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between March 3, 2008, and March 31, 2014, we randomly assigned 1108 patients to receive a sliding hip screw (n=557) or cancellous screws (n=551). Reoperations within 24 months did not differ by type of surgical fixation in those included in the primary analysis: 107 (20%) of 542 patients in the sliding hip screw group versus 117 (22%) of 537 patients in the cancellous screws group (hazard ratio [HR] 0·83, 95% CI 0·63–1·09; p=0·18). Avascular necrosis was more common in the sliding hip screw group than in the cancellous screws group (50 patients [9%] vs 28 patients [5%]; HR 1·91, 1·06–3·44; p=0·0319). However, no significant difference was found between the number of medically related adverse events between groups (p=0·82; appendix); these events included pulmonary embolism (two patients [

Published
2017

5. Prognostic Factors for Successful Recovery After Arthroscopic Rotator Cuff Repair: A Systematic Literature Review

Author

Ronald N. Wessel, Nienke Wolterbeek, Jean-Pierre Baeyens, Anouk J.M. Fermont, Rob A. de Bie, Epidemiologie, RS: CAPHRI School for Public Health and Primary Care, RS: CAPHRI - Epidemiology of musculoskeletal Disorders, Faculty of Physical Education and Physical Therapy, Biomechanics and Human Biometry, and Biomechanics

Subjects
Male, medicine.medical_specialty, Treatment outcome, Physical Therapy, Sports Therapy and Rehabilitation, Arthroscopy, Rotator Cuff, medicine, Humans, Rotator cuff, Shoulder disorder, Tendon healing, Aged, Surgical repair, medicine.diagnostic_test, business.industry, General Medicine, Middle Aged, Prognosis, Surgery, Treatment Outcome, medicine.anatomical_structure, Systematic review, Female, business, Systematic search
Abstract

STUDY DESIGN: Systematic literature review. OBJECTIVES: To perform a systematic review of the literature on prognostic factors for successful recovery after arthroscopic rotator cuff repair. BACKGROUND: Rotator cuff lesion is a common shoulder disorder, with a prevalence ranging from 13% in people over 50 years of age to more than 50% in people over 80 years of age. Several factors can affect the extent to which a person will recover after the surgical repair of a rotator cuff tear. More knowledge about these prognostic factors may lead to a better understanding of why the recovery process is successful in some patients but not in others. METHODS: A systematic literature search from 1995 to November 2013 was performed to identify studies reporting prognostic factors for successful recovery after arthroscopic rotator cuff repair. RESULTS: A total of 455 studies were initially identified, 10 of which were included in the review. For all included studies, the percentage of patients with complete tendon healing at final assessment ranged from 60% to 88%. Twelve prognostic factors, which could be divided into 4 categories, were identified as being associated with better recovery: demographic factors (younger age, male gender), clinical factors (higher bone mineral density, absence of diabetes mellitus, higher level of sports activity, greater preoperative range of motion, absence of obesity), factors related to cuff integrity (smaller sagittal size of the cuff lesion, less retraction of the cuff, less fatty infiltration, no multiple tendon involvement), and factors related to the surgical procedure (no concomitant biceps or acromioclavicular joint procedures). CONCLUSION: Knowledge and understanding of prognostic factors should be used in the decision-making process concerning arthroscopic rotator cuff repair to offer better care to patients. LEVEL OF EVIDENCE: Prognosis, level 2a-.

Published
2014

6. Abduction Brace Versus Antirotation Sling After Arthroscopic Cuff Repair: The Effects on Pain and Function

Author

Jacco A. C. Zijl, Ronald N. Wessel, Sjoerd P.M. van Egeraat, Freek Hollman, and Nienke Wolterbeek

Subjects
Adult, Male, medicine.medical_specialty, Sling (implant), Adolescent, Rotator Cuff Injuries, 03 medical and health sciences, Arthroscopy, Immobilization, Rotator Cuff, Young Adult, 0302 clinical medicine, 030202 anesthesiology, Medicine, Humans, Orthopedics and Sports Medicine, Rotator cuff, Postoperative Period, Range of Motion, Articular, Aged, Ultrasonography, Rupture, 030222 orthopedics, Pain, Postoperative, Braces, medicine.diagnostic_test, business.industry, Shoulder Joint, Rotator cuff injury, Recovery of Function, Middle Aged, musculoskeletal system, medicine.disease, Magnetic Resonance Imaging, Brace, Surgery, medicine.anatomical_structure, Treatment Outcome, Cuff, Quality of Life, Shoulder joint, Female, business, Range of motion, Follow-Up Studies
Abstract

Purpose To study the effects on pain as the main outcome parameter and on function and cuff integrity as the secondary outcome parameters after arthroscopic rotator cuff repair in the short term comparing the abduction brace with an antirotation sling for postoperative shoulder immobilization. Methods Eligible patients were between the ages of 18 and 75 years who were diagnosed with a traumatic or degenerative tear of the supraspinatus and/or infraspinatus tendon, confirmed by magnetic resonance imaging, for which an arthroscopic footprint repair was indicated and performed. Patients were randomly allocated to the antirotation sling or abduction brace group. Postoperative pain and use of analgesics were accurately registered up to 3 months after surgery using a patient diary. Follow-up examinations including the Constant-Murley score, Western Ontario Rotator Cuff index, and glenohumeral range of motion were scheduled 6 weeks, 3 and 6 months, and 1 year after surgery. Results The average level of pain measured directly postoperation up to 1 year after surgery was not significant different between groups. Postoperatively, function scores and glenohumeral range of motion improved significantly for both groups; however, no differences were observed between groups. No retears were observed on ultrasonograph 3 months after surgery. Conclusions In the short term, the level of pain, function, and quality of life were not significantly different between the use of an abduction brace and that of an antirotation sling after arthroscopic rotator cuff repair. Based on these findings, the abduction brace used in this study does not seem to be the solution for decreasing the pain experienced in the first postoperative weeks after arthroscopic rotator cuff repair, and both are recommendable. Level of Evidence Level I, randomized controlled trial.

Published
2016

7. Predictors of disease-specific quality of life after arthroscopic rotator cuff repair

Author

Ronald N. Wessel, Arjen Kolk, Jacco A. C. Zijl, Nienke Wolterbeek, and Kiem G. Auw Yang

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Arthroplasty, Cohort Studies, 03 medical and health sciences, Rotator Cuff, 0302 clinical medicine, Patient satisfaction, Quality of life, medicine, Humans, Orthopedics and Sports Medicine, Rotator cuff, Aged, Retrospective Studies, Rupture, 030222 orthopedics, medicine.diagnostic_test, business.industry, Arthroscopy, Retrospective cohort study, 030229 sport sciences, Odds ratio, Middle Aged, Prognosis, medicine.anatomical_structure, Patient Satisfaction, Physical therapy, Quality of Life, Surgery, Female, business, Cohort study, Follow-Up Studies
Abstract

Disease-specific instruments of quality of life (QOL) are more sensitive to disease-specific changes. The purpose of this study is to identify prognostic factors for disease-specific QOL after all-arthroscopic rotator cuff (RC) repair using the Western Ontario Rotator Cuff Index (WORC). A total of 140 patients were evaluated after an RC repair with a mean follow-up of 22 ± 6.7 months. Evaluations included the WORC, EQ-5D and anchor questions. Preoperative patient demographics and radiologic characteristics were assessed to identify predictors of disease-specific QOL. Most patients (81.4 %) were satisfied with their surgical result. Minor tear retraction (odds ratio [OR] 2.97, p = 0.030), male gender (OR 3.67, p = 0.003), no social benefits (OR 3.67, p = 0.042) and pre-surgical complaints for more than six months (OR 3.03, p = 0.021) were independent predictors for superior postoperative WORC score in multivariable analysis. None of these factors were predictive for a higher EQ-5D score. These findings highlight the important impact of retraction on QOL after RC repair and underline the utility of disease-specific instruments. Future studies should focus on how these significant predictors can be used to improve decision making and to develop new treatment approaches.

Published
2015

8. Reliability, Validity, and Responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index for Elderly Patients with a Femoral Neck Fracture

Author

Paul T.P.W. Burgers, Rudolf W Poolman, Theodorus MJ Van Bakel, Wim E Tuinebreijer, Stephanie M Zielinski, Mohit Bhandari, Peter Patka, Esther MM Van Lieshout, P J Devereaux, Gordon H Guyatt, Thomas A Einhorn, Lehana Thabane, Emil H Schemitsch, Kenneth J Koval, Frede Frihagen, Kevin Tetsworth, Ernesto Guerra-Farfan, Stephen D Walter, Sheila Sprague, Marilyn Swinton, Taryn Scott, Paula McKay, Kim Madden, Diane Heels-Ansdell, Lisa Buckingham, Aravin Duraikannan, Heather Silva, Martin J Heetveld, Robert D Zura, Victoria Avram, Ajay Manjoo, Dale Williams, John Antoniou, Tim Ramsay, Earl R Bogoch, Andrew Trenholm, Stephen Lyman, Madhu Mazumdar, Kevin J Bozic, Mark Luborsky, Stuart Goodman, Susan Muray, Rob Korley, Richard Buckley, Paul Duffy, Shannon Puloski, Kimberly Carcary, Melissa Lorenzo, Michael D McKee, Jeremy A Hall, Aaron Nauth, Daniel Whelan, Timothy R Daniels, James P Waddell, Henry Ahn, Milena R Vicente, Jennifer T Hidy, Melanie T MacNevin, Hans Kreder, Terry Axelrod, Richard Jenkinson, Markku Nousiainen, David Stephen, Veronica Wadey, Monica Kunz, Katrine Milner, Ria Cagaanan, Melanie MacNevin, Peter J O’Brien, Piotr A Blachut, Henry M Broekhuyse, Pierre Guy, Kelly A Lefaivre, Gerard P Slobogean, Raman Johal, Irene Leung, Chad Coles, Ross Leighton, C. Glen Richardson, Michael Biddulph, Michael Gross, Michael Dunbar, J. David Amirault, David Alexander, Catherine Coady, Mark Glazebrook, David Johnston, William Oxner, Gerald Reardon, Ivan Wong, Kelly Trask, Shelley MacDonald, Andrew Furey, Craig Stone, Minnie Parsons, Trevor Stone, Mauri Zomar, Robert McCormack, Kelly Apostle, Dory Boyer, Farhad Moola, Bertrand Perey, Darius Viskontas, Karyn Moon, Raely Moon, Yves Laflamme, Benoit Benoit, Pierre Ranger, Michel Malo, Julio Fernandes, Karine Tardif, Julie Fournier, Pascal André Vendittoli, Vincent Massé, Alain G Roy, Martin Lavigne, Daniel Lusignan, Craig Davis, Philip Stull, Stewart Weinerman, Peter Weingarten, Steven Lindenbaum, Michael Hewitt, Rebecca Danielwicz, Janell Baker, Michael Mont, Donald E Delanois, Bhaveen Kapadia, Kimona Issa, Marylou Mullen, Andrew Sems, Barb Foreman, Javad Parvizi, Tiffany Morrison, Courtland Lewis, Stephanie Caminiti, Paul Tornetta, William R Creevy, Michelle J Lespasio, Hope Carlisle, Andrew Marcantonio, Michael Kain, Lawrence Specht, John Tilzey, John Garfi, Samir Mehta, John L Esterhai, Jaimo Ahn, Derek Donegan, Annamarie Horan, Kelly McGinnis, James Roberson, Thomas Bradbury, Greg Erens, Kyle Webb, Brian Mullis, Karl Shively, Andrew Parr, Janos Ertl, Ripley Worman, Mark Webster, Judd Cummings, Valda Frizzell, Molly Moore, Clifford B Jones, James R Ringler, Debra L Sietsema, Jane E Walker, Enes Kanlic, Amr Abdelgawad, Juan Shunia, Charles DePaolo, Susan Sutherland, Rachel Alosky, Robert Zura, Maria Manson, Gregg Strathy, Kathleen Peter, Paul Johnson, Meaghan Morton, James Shaer, Tyson Schrickel, Barbara Hileman, Marina Hanes, Elisha Chance, E. Matthew Heinrich, David Dodgin, Michele LaBadie, David Zamorano, Martin Tynan, Ran Schwarzkopf, John A Scolaro, Ranjan Gupta, Samuel Bederman, Nitin Bhatia, Bang Hoang, Douglas Kiester, Neil Jones, Gregory Rafijah, Damon Alavekios, Jason Lee, Akshay Mehta, Steven Schroder, Tom Chao, Vincent Colin, Phuc (Phil) Dang, Stephen Keun Heng, Gregory Lopez, Samuel Galle, Sohrab Pahlavan, Duy L Phan, Minal Tapadia, Christopher Bui, Nickul Jain, Tyler Moore, Nathan Moroski, Deeba Pourmand, Erik N Kubiak, Jeremy Gililland, David Rothberg, Christopher Peters, Christopher Pelt, Ami R Stuart, Kirby Corbey, Franklin D Shuler, James Day, Tigran Garabekyan, Felix Cheung, Ali Oliashirazi, Jonathon Salava, Linda Morgan, Timothy Wilson-Byrne, Mary Beth Cordle, Leon H.G.J. Elmans, Joost A.A.M. van den Hout, Adrianus JP Joosten, Ad FA van Beurden, Stefan BT Bolder, Denise Eygendaal, Adrianus F.C.M. Moonen, Rutger CI van Geenen, Eric A Hoebink, Robert Wagenmakers, Wouter van Helden, Hans-Peter W van Jonbergen, Herbert Roerdink, Joost M Reuver, Alexander FW Barnaart, Elvira R Flikweert, Rover Krips, J. Bernard Mullers, Hans Schüller, Mark LM Falke, Frans J Kurek, Adrianus CH Slingerland, Jan P van Dijk, Wouter H van Helden, Hugo W Bolhuis, Pieter HJ Bullens, Mike Hogervorst, Karin E de Kroon, Rob H Jansen, Ferry Steenstra, Eric EJ Raven, W. Peter J Fontijne, Saskia C Wiersma, Bastiaan Boetes, Edgar JT ten Holder, Huub JL van der Heide, Jochem Nagels, Enrike H.M.J. van der Linden-van der Zwaag, Stefan B Keizer, Jan-Willem A Swen, Peter HC den Hollander, Bregje JW Thomassen, Willem Jan Kleyn Molekamp, Frank R.A.J. de Meulemeester, Arthur EB Kleipool, Robert Haverlag, Maarten P Simons, Eduard L.A.R. Mutsaerts, Rob Kooijman, Roelf R Postema, René J.T.M. Bleker, Harald IH Lampe, Lein Schuman, John Cheung, Frank van Bommel, W. Paul Winia, Daniel Haverkamp, Harm van der Vis, Peter A Nolte, Michel PJ van den Bekerom, Tjitte de Jong, Arthur van Noort, Diederik A Vergroesen, Bernard G Schutte, Harm M van der Vis, Lijkele Beimers, Jasper de Vries, Arthur W Zurcher, G.H. Rob Albers, Maarten Rademakers, Stefan Breugem, Ibo van der Haven, Pieter Jan Damen, Gythe H Bulstra, Martin M Campo, Mathijs P Somford, Daniël Haverkamp, Susan Liew, Harvinder Bedi, Ashley Carr, Andrew Chia, Steve Csongvay, Craig Donohue, Stephen Doig, Elton Edwards, Max Esser, Richard Freeman, Andrew Gong, Doug Li, Russell Miller, Lu Ton, Otis Wang, Ian Young, Adam Dowrick, Zoe Murdoch, Claire Sage, Richard Page, David Bainbridge, Richard Angliss, Ben Miller, Andrew Thomson, Graeme Brown, Simon Williams, Kevin Eng, David Bowyer, John Skelley, Chatar Goyal, Sally Beattie, Enrique Guerado, Encarnacion Cruz, Juan Ramon Cano, Miguel Angel Froufe, Lluis Marull Serra, Samer Al-dirra, Cristina Martinez, Francisco José Tarazona Santabalbina, Jordi Teixidor Serra, Jordi Tomas Hernandez, Marc Aguilar Garcia, Vicente Molero Garcia, Sergi Barrera, Miriam Garrido, Lars Nordsletten, John Clarke-Jenssen, Geir Hjorthaug, Anne Christine Brekke, Elise Berg Vesterhus, Ingunn Skaugrud, Pradeep Tripathi, Sandesh Katiyar, Preksha Shukla, Marc Swiontkowski, Gordon Guyatt, Kyle Jeray, Stephen Walter, Helena Viveiros, Victoria Truong, Kaitlin Koo, Qi Zhou, Deborah Maddock, Nicole Simunovic, Julie Agel, Amar Rangan, Birgit C Hanusch, Lucksy Kottam, Rachel Clarkson, Gregory J Della Rocca, Gerard Slobogean, Jeffrey Katz, Brenda Gillespie, Gail A Greendale, Curtis Hartman, Craig Rubin, James Waddell, H. Michael Lemke, Amber Oatt, Richard E Buckley, Robert Korley, Kelly Johnston, James Powell, David Sanders, Abdel Lawendy, Christina Tieszer, John Murnaghan, Diane Nam, Albert Yee, Daniel B Whelan, Lisa M Wild, Ryan M Khan, Cathy Coady, David Amirault, Glen Richardson, Gwen Dobbin, Ryan Bicknell, Jeff Yach, Davide Bardana, Gavin Wood, Mark Harrison, David Yen, Sue Lambert, Fiona Howells, Angela Ward, Paul Zalzal, Heather Brien, V Naumetz, Brad Weening, Eugene K Wai, Steve Papp, Wade T Gofton, Stephen P Kingwell, Garth Johnson, Joseph O’Neil, Darren M Roffey, Vivian Borsella, Todd M Oliver, Vicki Jones, Terrence J Endres, Samuel G Agnew, Kyle J Jeray, J. Scott Broderick, David R Goetz, Thomas B Pace, Thomas M Schaller, Scott E Porter, Stephanie L Tanner, Rebecca G Snider, Lauren A Nastoff, Shea A Bielby, Julie A Switzer, Peter A Cole, Sarah A Anderson, Paul M Lafferty, Mengnai Li, Thuan V Ly, Scott B Marston, Amy L Foley, Sandy Vang, David M Wright, Andrew J Marcantonio, Michael SH Kain, Richard Iorio, Lawrence M Specht, John F Tilzey, Margaret J Lobo, John S Garfi, Heather A Vallier, Andrea Dolenc, Chalitha Robinson, Michael J Prayson, Richard Laughlin, L. Joseph Rubino, Jedediah May, Geoffrey Ryan Rieser, Liz Dulaney-Cripe, Chris Gayton, John T Gorczyca, Jonathan M Gross, Catherine A Humphrey, Stephen Kates, Krista Noble, Allison W McIntyre, Kaili Pecorella, Craig A Davis, Stephen Lindenbaum, John Schwappach, Janell K Baker, Tori Rutherford, Heike Newman, Shane Lieberman, Erin Finn, Kristin Robbins, Meghan Hurley, Lindsey Lyle, Khalis Mitchell, Kieran Browner, Erica Whatley, Krystal Payton, Christina Reeves, Lisa K Cannada, David Karges, Leslie Hill, John Esterhai, Annamarie D Horan, Christine A Kaminski, Brynn N Kowalski, Jonathan P Keeve, Christopher G Anderson, Michael D McDonald, Jodi M Hoffman, Ivan Tarkin, Peter Siska, Gary Gruen, Andrew Evans, Dana J Farrell, James Irrgang, Arlene Luther, William W Cross, Joseph R Cass, Stephen A Sems, Michael E Torchia, Tyson Scrabeck, Mark Jenkins, Jules Dumais, Amanda W Romero, Carlos A Sagebien, Mark S Butler, James T Monica, Patricia Seuffert, Joseph R Hsu, James Ficke, Michael Charlton, Matthew Napierala, Mary Fan, Chadi Tannoury, Michael Archdeacon, Ryan Finnan, Toan Le, John Wyrick, Shelley Hess, Michael L Brennan, Robert Probe, Evelyn Kile, Kelli Mills, Lydia Clipper, Michelle Yu, Katie Erwin, Daniel Horwitz, Kent Strohecker, Teresa K Swenson, Andrew H Schmidt, Jerald R Westberg, Kamran Aurang, Gary Zohman, Brett Peterson, Roger B Huff, Joseph Baele, Timothy Weber, Matt Edison, Jessica McBeth, Janos P Ertl, J. Andrew Parr, Molly M Moore, Erin Tobias, Emily Thomas, Charles J DePaolo, Leslie E Shell, Lynne Hampton, Stephanie Shepard, Tracy Nanney, Claudine Cuento, Robert V Cantu, Eric R Henderson, Linda S Eickhoff, E. Mark Hammerberg, Philip Stahel, David Hak, Cyril Mauffrey, Douglas Gibula, Hannah Gissel, Corey Henderson, David P Zamorano, Martin C Tynan, Deanna Lawson, Brett D Crist, Yvonne M Murtha, Linda K Anderson, Colleen Linehan, Lindsey Pilling, Courtland G Lewis, Raymond J Sullivan, Elizabeth Roper, William Obremskey, Philip Kregor, Justin E Richards, Kenya Stringfellow, Michael P Dohm, Abby Zellar, Michiel JM Segers, Jacco AC Zijl, Bart Verhoeven, Anke B Smits, Jean Paul PM de Vries, Bram Fioole, Henk van der Hoeven, Evert BM Theunissen, Tammo S de Vries Reilingh, Lonneke Govaert, Philippe Wittich, Maurits de Brauw, Jan Wille, Peter M.N.Y.M. Go, Ewan D Ritchie, Ronald N Wessel, Eric R Hammacher, Gijs A Visser, Heyn Stockmann, Rob Silvis, Jaap P Snellen, Bram Rijbroek, Joris JG Scheepers, Erik GJ Vermeulen, Michiel PC Siroen, Ronald Vuylsteke, Hans LF Brom, Herman Rijna, Piet AR de Rijcke, Cees L Koppert, Steven E Buijk, Richard PR Groenendijk, Imro Dawson, Geert WM Tetteroo, Milko MM Bruijninckx, Pascal G Doornebosch, Eelco JR de Graaf, Maarten van der Elst, Carmen C van der Pol, Martijne van’t Riet, Tom M Karsten, Mark R de Vries, Laurents PS Stassen, Niels WL Schep, G Ben Schmidt, W H Hoffman, Frank H.W.M. van der Heijden, W. Jaap Willems, Cor P van der Hart, Kahn Turckan, Sebastiaan Festen, Frank de Nies, Nico JM Out, Jan Bosma, Albert van Kampen, Jan Biert, Arie B van Vugt, Michael JR Edwards, Taco J Blokhuis, Jan Paul M Frölke, Leo MG Geeraedts, Jean WM Gardeniers, Edward T.C.H. Tan, Lodewijk M.S.J. Poelhekke, Maarten C de Waal Malefijt, Bart Schreurs, Gert R Roukema, Hong A Josaputra, Paul Keller, Peter D de Rooij, Hans Kuiken, Han Boxma, Berry I Cleffken, Ronald Liem, Steven J Rhemrev, Coks HR Bosman, Alexander de Mol van Otterloo, Jochem Hoogendoorn, Alexander C de Vries, Sven AG Meylaerts, Michiel HJ Verhofstad, Joost Meijer, Teun van Egmond, Igor van der Brand, Martin G Eversdijk, Rolf Peters, Dennis Den Hartog, Oscar JF Van Waes, Pim Oprel, Martin Campo, Ronald Verhagen, G.H. Robert Albers, Rogier KJ Simmermacher, Jeroen van Mulken, Karlijn van Wessem, Steven M van Gaalen, Luke PH Leenen, Maarten W.G.A. Bronkhorst, Onno R Guicherit, J. Carel Goslings, Kees Jan Ponsen, Mahesh Bhatia, Vinod Arora, Vivek Tyagi, Ajay Gupta, Neeraj Jain, Farah Khan, Ateet Sharma, Amir Sanghavi, Mittal Trivedi, Anil Rai, null Subash, Kamal Rai, Vineet Yadav, Sanjay Singh, Amal Shankar Prasad, Vimlesh Mishra, D C Sundaresh, Angshuman Khanna, Joe Joseph Cherian, Davy J Olakkengil, Gaurav Sharma, Akhil Dadi, Naveen Palla, Utsav Ganguly, B. Sachidananda Rai, Janakiraman Rajakumar, Peter Hull, Sophie Lewis, Simone Evans, Rajesh Nanda, Rajanikanth Logishetty, Sanjeev Anand, Carol Bowler, Andrew Jennings, Graham Chuter, Glynis Rose, Gillian Horner, Callum Clark, Kate Eke, Mike Reed, Chris Herriott, Christine Dobb, Hamish Curry, Greg Etherington, Arvind Jain, Ash Moaveni, Matthias Russ, Geoff Donald, Patrick Weinrauch, Paul Pincus, Steven Yang, Brett Halliday, Trevor Gervais, Michael Holt, Annette Flynn, Marinis Pirpiris, David Love, Andrew Bucknill, Richard J Farrugia, Torben Ianssen, Asgeir Amundsen, Jan Egil Brattgjerd, Tor Borch, Berthe Bøe, Bernhard Flatøy, Sondre Hasselund, Knut Jørgen Haug, Kim Hemlock, Tor Magne Hoseth, Geir Jomaas, Thomas Kibsgård, Tarjei Lona, Gilbert Moatshe, Oliver Müller, Marius Molund, Tor Nicolaisen, Fredrik Nilsen, Jonas Rydinge, Morten Smedsrud, Are Stødle, Axel Trommer, Stein Ugland, Anders Karlsten, Guri Ekås, Hans-Christoph Pape, Matthias Knobe, Roman Pfeifer, Orthopedic Surgery and Sports Medicine, Graduate School, Other departments, Surgery, Other Research, Amsterdam Movement Sciences, Cardiothoracic Surgery, and Emergency Medicine

Subjects
Male, medicine.medical_specialty, WOMAC, Abstracting and Indexing, Osteoarthritis, Cronbach's alpha, Surveys and Questionnaires, medicine, Humans, Orthopedics and Sports Medicine, Clinical significance, Femoral neck, Aged, 80 and over, Ontario, business.industry, Reproducibility of Results, Construct validity, General Medicine, medicine.disease, RELIABILITY VALIDITY, Femoral Neck Fractures, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Clinical trial, Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10], medicine.anatomical_structure, Physical therapy, Female, Surgery, business
Abstract

Item does not contain fulltext BACKGROUND: The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been extensively evaluated in groups of patients with osteoarthritis, yet not in patients with a femoral neck fracture. This study aimed to determine the reliability, construct validity, and responsiveness of the WOMAC compared with the Short Form-12 (SF-12) and the EuroQol 5D (EQ-5D) questionnaires for the assessment of elderly patients with a femoral neck fracture. METHODS: Reliability was tested by assessing the Cronbach alpha. Construct validity was determined with the Pearson correlation coefficient. Change scores were calculated from ten weeks to twelve months of follow-up. Standardized response means and floor and ceiling effects were determined. Analyses were performed to compare the results for patients less than eighty years old with those for patients eighty years of age or older. RESULTS: The mean WOMAC total score was 89 points before the fracture in the younger patients and increased from 70 points at ten weeks to 81 points at two years postoperatively. In the older age group, these scores were 86, 75, and 78 points. The mean WOMAC pain scores before the fracture and at ten weeks and two years postoperatively were 92, 76, and 87 points, respectively, in the younger age group and 92, 84, and 93 points in the older age group. Function scores were 89, 68, and 79 points for the younger age group and 84, 71, and 73 points for the older age group. The Cronbach alpha for pain, stiffness, function, and the total scale ranged from 0.83 to 0.98 for the younger age group and from 0.79 to 0.97 for the older age group. Construct validity was good, with 82% and 79% of predefined hypotheses confirmed in the younger and older age groups, respectively. Responsiveness was moderate. No floor effects were found. Moderate to large ceiling effects were found for pain and stiffness scales at ten weeks and twelve months in younger patients (18% to 36%) and in the older age group (38% to 53%). CONCLUSIONS: The WOMAC showed good reliability, construct validity, and responsiveness in both age groups of elderly patients with a femoral neck fracture who had been physically and mentally fit before the fracture. The instrument is suitable for use in future clinical studies in these populations. CLINICAL RELEVANCE: The results are based on two clinical trials. The questionnaires used concern pure, clinically relevant issues (ability to walk, climb stairs, etc.). Moreover, the results can be used for future research comparing clinical outcomes (or treatments) for populations with a femoral neck fracture.

Published
2015

9. Prognostic factors for recovery after arthroscopic rotator cuff repair: A prognostic study

Author

Jean-Pierre Baeyens, Ronald N. Wessel, Rob A. de Bie, Anouk J.M. Fermont, Nienke Wolterbeek, Movement and Nutrition for Health and Performance, Movement and Sport Sciences, Biomechanics, Epidemiologie, RS: CAPHRI School for Public Health and Primary Care, and RS: CAPHRI - R3 - Functioning, Participating and Rehabilitation

Subjects
Adult, Male, Prognostic factor, medicine.medical_specialty, Rotator Cuff Injuries, Arthroscopy, Rotator Cuff, Quality of life, medicine, Humans, Orthopedics and Sports Medicine, Rotator cuff, Prospective Studies, Range of Motion, Articular, Prospective cohort study, Aged, Rupture, Shoulder Joint, business.industry, Shoulder, arthroscopic repair, prognostic factors, quality of life, rotator cuff lesion, Recovery of Function, General Medicine, Middle Aged, Prognosis, Functional recovery, Tendon, Surgery, Treatment Outcome, medicine.anatomical_structure, Cuff, Quality of Life, Female, Shoulder Injuries, business, Range of motion, Follow-Up Studies
Abstract

Background Studies concerning prognostic factors of recovery after arthroscopic rotator cuff repair mostly focus on tendon integrity or functional recovery as an outcome. Little is known about how they influence quality of life after surgery. We therefore tried to identify prognostic factors having an impact on quality of life after arthroscopic rotator cuff repair. Methods This study included 30 patients who underwent arthroscopic rotator cuff repair. We assessed Western Ontario Rotator Cuff Index as primary outcome and RAND-36, Constant-Murley score, and a shoulder hindrance score as secondary outcomes. Patients were repeatedly measured: once preoperatively and 4 times postoperatively. Preoperative range of motion, obesity, fatty infiltration, and cuff retraction were preselected as prognostic factors. Results Patients were significantly improved at 3 months and 6 months after arthroscopic rotator cuff repair. In multiple regression analysis, none of the preselected factors could be identified as a prognostic factor influencing quality of life after arthroscopic rotator cuff repair (measured with the Western Ontario Rotator Cuff Index). For the outcome variables RAND-36 (6 months, 1 year) and shoulder hindrance score (1 year), fatty infiltration Goutallier stages 1 and 2 and retraction grades II, III, and IV were significant predictors. Conclusion Although fatty infiltration and retraction grade predict the RAND-36 and shoulder hindrance score, this study could not support preoperative range of motion, obesity, fatty infiltration, or retraction of the cuff as a prognostic factor for quality of life after arthroscopic rotator cuff repair. This study shows that if selection of patients is done properly, these factors do not influence a successful outcome.

Published
2015

10. The Anterior Ankle Impingement Syndrome: Diagnostic Value of Oblique Radiographs

Author

C. Niek van Dijk, Ronald N. Wessel, Rover Krips, Ronald A. W. Verhagen, Johannes L. Tol, Mario Maas, Marcel G. W. Dijkgraaf, Orthopedic Surgery and Sports Medicine, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, AMS - Amsterdam Movement Sciences, Radiology and Nuclear Medicine, APH - Amsterdam Public Health, and Epidemiology and Data Science

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Radiography, Pain, Arthroscopy, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Orthopedics and Sports Medicine, Prospective Studies, Exostoses, Mri scan, Aged, 030203 arthritis & rheumatology, medicine.diagnostic_test, business.industry, Oblique case, Syndrome, 030229 sport sciences, Anterior ankle impingement, Middle Aged, respiratory system, respiratory tract diseases, Surgery, medicine.anatomical_structure, Female, Ankle, Joint Diseases, business, Nuclear medicine
Abstract

Background: The diagnostic value of an oblique radiograph, in addition to a lateral radiograph, for detecting osteophytes in the anterior ankle impingement syndrome was evaluated in a prospective study. The hypothesis was that the application of a lateral radiograph is insufficient to detect osteophytes that are located in the anteromedial aspect of the ankle joint. Oblique anteromedial impingement (AMI) radiographs were hypothesized to be a relevant adjunct, because of their utility to detect these anteromedially located osteophytes. Methods: Presence or absence of tibial and talar osteophytes on both radiographs was compared with the combined findings of CT, MRI scan, and arthroscopic surgery. Estimates of test characteristics were obtained for 60 consecutive patients with an anterior ankle impingement syndrome. Results: It was shown that the sensitivity of lateral radiographs for detecting anterior tibial and talar osteophytes was 40% and 32%, respectively (specificity, 70% and 82%). When the lateral radiograph was combined with an oblique AMI radiograph, these figures increased to 85% and 73%, respectively (specificity decreased to 45% and 68%). This increase was due to the high sensitivity of the oblique AMI radiographs for detecting anteromedial osteophytes (93% for tibial and 67% for talar osteophytes). Conclusion: A lateral radiograph is insufficient to detect all anteriorly located osteophytes. An oblique AMI radiograph is a useful adjunct to routine radiographs and is recommended to detect anteromedial tibial and talar osteophytes.

Published
2004

11. The conceptually equivalent Dutch version of the Western Ontario Rotator Cuff Index (WORC)(c)

Author

Ronald N. Wessel, Nienke Wolterbeek, Anouk J.M. Fermont, Rob A. de Bie, Sharon Griffin, Heleen Sonneveld, Henk van Mameren, RS: CAPHRI School for Public Health and Primary Care, and Epidemiologie

Subjects
Adult, Male, medicine.medical_specialty, Intraclass correlation, Population, Severity of Illness Index, Rotator Cuff, Rheumatology, Cronbach's alpha, Validation, Medicine, Humans, Quality of life questionnaires, Rotator cuff repair, Orthopedics and Sports Medicine, Rotator cuff, Prospective Studies, education, Reliability (statistics), Aged, Netherlands, Aged, 80 and over, education.field_of_study, Arm Injuries, business.industry, WORC, Middle Aged, Confidence interval, Standard error, medicine.anatomical_structure, Physical therapy, Translation process, Constant score, Female, business, Research Article
Abstract

The WORC is a quality of life questionnaire designed for patients with disorders of the rotator cuff, originally developed in English. The purpose of this study was to cross-culturally adapt the WORC for use in the Dutch population and to evaluate reliability, agreement and floor and ceiling effects of this Dutch version in a population of patients with rotator cuff disease. Reliability was tested by measuring the Cronbach’s alpha for internal consistency and intraclass correlation coefficients (ICC) for test-retest reliability. Agreement was measured using the Standard Error of Measurement (SEMagreement); and the smallest detectable change (SDC) was calculated based on the SEM. Pearson Correlations Coefficients were used to comparing the WORC with the RAND-36, the Constant Score and 11-point shoulder hindrance scale. Fifty-seven patients entered into this study of whom 50 were available for test-retest validation. The internal consistency of the Dutch WORC tested by Cronbach’s alpha was 0.95 for the total questionnaire. The ICC for the WORC is 0.91 with a 95% confidence interval of 0.85-0.95. Standard Error of Measurement was 6.0 points with a Smallest Detectable Change of 16.7 points on a 0-100 scale. Pearson Correlations Coefficients showed a significant positive correlation between the Dutch WORC and Constant Score (r = 0.60) and a strong reversed correlation with the shoulder hindrance scale (r = -0.75). The Dutch WORC seems to be a reliable health-related quality of life questionnaire for patients with rotator cuff disorders. NCT01532492 .

Published
2013

12. Outcome of total claviculectomy in six cases

Author

Ronald N. Wessel, Gerard R. Schaap, Other Research, and Orthopedic Surgery and Sports Medicine

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Radiography, Bone Neoplasms, Malignancy, Risk Assessment, Cohort Studies, Fractures, Bone, Biopsy, medicine, Humans, Orthopedics and Sports Medicine, Child, Total claviculectomy, medicine.diagnostic_test, business.industry, Biopsy, Needle, Osteomyelitis, General Medicine, Middle Aged, medicine.disease, Clavicle, Surgery, Osteotomy, medicine.anatomical_structure, Treatment Outcome, Acromioclavicular Joint, Female, Osteitis, business, Range of motion, Cohort study, Follow-Up Studies
Abstract

Total claviculectomy is a rare surgical procedure that has been performed for more than 90 years for a variety of indications, such as malignancy, trauma, and infection. What are the results for the pain score, and what is the influence of a total claviculectomy on the range of motion of the shoulder? We could not find the answers in the literature and analyzed 6 cases of total claviculectomy. The pain scores are good in a chronic osteitis case and in the two malignancy cases. In the 3 posttraumatic cases, the indication was pain, and all 3 had poor results because of persistent pain. All 6 patients had full range of motion. A resection of the entire clavicle did not disturb the motion of the shoulder. A tendency but no final conclusions can be drawn because of too few patients and heterogeneous indications.

Published
2007

13. Oblique radiograph for the detection of bone spurs in anterior ankle impingement

Author

Mario Maas, Niek C. van Dijk, Johannes L. Tol, Ronald N. Wessel, Orthopedic Surgery and Sports Medicine, and Radiology and Nuclear Medicine

Subjects
Adult, Male, medicine.medical_specialty, Radiography, Oblique projection, Osteoarthritis, Talus, Cadaver, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Exostoses, Observer Variation, Tibia, medicine.diagnostic_test, business.industry, Arthroscopy, Anatomy, Middle Aged, medicine.disease, Biomechanical Phenomena, medicine.anatomical_structure, Orthopedic surgery, Bone spurs, Female, Ankle, medicine.symptom, business, Ankle Joint
Abstract

Objective: The aim of this study was to develop a radiographic view to detect anteromedial talotibial osteophytes that remain undetected on standard radiographs. Design and patients: In 10 cadaver specimens the maximal size was measured of anteromedial tibial osteophytes that remain undetected on a standard lateral radiograph projection, due to the presence of the anteromedial fibial rim. The average projection of the most prominent anterolateral tibial rim over the anteromedial rim was found to be 7.3 mm. A 7 mm barium-clay osteophyte was attached to this anteromedial rim of the distal tibia. Anteromedial osteophytes become most prominent on an oblique view, in which the radiographic beam is tilted into a 45degrees craniocaudal direction with the leg in 30degrees external rotation. This oblique view was compared with the findings of arthroscopic surgery in 25 consecutive patients with anterior ankle impingement syndrome. Results: Medially located tibial and talar osteophytes remained undetected on a standard lateral projection and became visible on the oblique anteromedial impingement (AMI) radiograph. Anterolateral tibial and talar osteophytes were well detected on a standard lateral radiograph projection but were invisible on the AMI view. There was a high correlation between the location of the osteophyte and the location of symptoms and the findings at arthroscopy. Conclusion: A combination of lateral and oblique radiographs can be used to differentiate between anteromedial and anterolateral bony ankle impingement

Published
2002

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