bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimal Clinically Important Difference of Patient Reported Outcome Measures of Lower Extremity Injuries in Orthopedics
Authors: Çelik Derya , Çoban Özge , Kılıçoğlu Önder 
Published: March 2017

Purpose: MCID scores for outcome measures are frequently used evidence-based guides to gage meaningful changes. To conduct a systematic review of the quality and content of the the minimal clinically important difference (MCID) relating to 16 patient-rated outcome measures (PROM) used in lower extremity. Methods: We conducted a systematic literature review on articles reporting MCID in lower extremity outcome measures and orthopedics from January 1, 1980, to May 10, 2016. We evaluated MCID of the 16 patient reported outcome measures (PROM) which were Harris Hip Score (HHS), Oxford Hip Score (OHS), Hip Outcome Score (HOS), Hip Disability and Osteoarthritis Outcome Score (HOOS), The International Knee Documentation Committee Subjective Knee Form (IKDC), The Lysholm Scale, The Western Ontario Meniscal Evaluation Tool (WOMET), The Anterior Cruciate Ligament Quality of Life Questionnaire (ACL-QOL), The Lower Extremity Functional Scale (LEFS), The Western Ontario and Mcmaster Universities Index (WOMAC), Knee İnjury And Osteoarthritis Outcome Score (KOOS), Oxford Knee Score (OKS), Kujala Anterior Knee Pain Scale, The Victorian Institute of Sports Assessment Patellar Tendinosis (Jumper’s Knee) (VİSA-P), Tegner Activity Rating Scale, Marx Activity Rating Scale, Foot And Ankle Outcome Score (FAOS), The Foot Function Index (FFI), Foot And Ankle Ability Measure (FAAM), The Foot And Ankle Disability Index Score and Sports Module, Achill Tendon Total Rupture Score(ATRS), The Victorian İnstitute Of Sports Assesment Achilles Questionnaire(VİSA-A), American Orthopaedic Foot and Ankle Society (AOFAS). A search of the PubMed/MEDLINE, PEDro and Cochrane Cen¬tral Register of Controlled Trials and Web of Science databases from the date of inception to May 1, 2016 was conducted. The terms “minimal clinically important difference,” “minimal clinically important change”, “minimal clinically important improvement” “were combined with one of the PROM as mentioned above. Results: A total of 223 abstracts were reviewed and 119 articles chosen for full text review. Thirty articles were included in the final evaluation. The MCID was mostly calculated for WOMAC and frequently reported in knee and hip osteoartritis, knee and hip atrhroplasties, femoraasetabular impingement syndrome and focal cartilage degeneration. In addition, Receiver Operating Characteristic (ROC) analysis was the most used method to report MCID. Conclusions: MCID is an important concept used to determine whether a medical intervention improves perceived outcomes in patients. Despite an abundance of methods reported in the literature, little work in MCID estimation has been done in the PRAM related to lower extremity. There is a need for future studies in this regard.
Outcome of the treatment of chronic isolated and combined posterolateral corner knee injuries with 2- to 6-year follow-up
Authors: Görmeli Gökay , Görmeli Cemile Ayşe , Elmalı Nurzat , Karakaplan Mustafa , Ertem Kadir , Ersoy Yüksel 
Published: March 2017

Introduction: Injuries of the posterolateral corner (PLC) of the knee are rare. They are difficult to diagnose and can cause severe disability. This study presents the 20- to 70-month clinical and radiological outcomes of the anatomical reconstruction technique of LaPrade et al. Materials and methods Twenty-one patients with chronic PLC injuries underwent anatomical PLC reconstruction. The anatomical locations of the popliteus tendon, fibular collateral ligament, and popliteofibular ligament were reconstructed using a 2-graft technique. The patients were evaluated subjectively with the Tegner, Lysholm, and International Knee Documentation Committee (IKDC) subjective knee scores and objectively with the IKDC objective scores; additionally, varus stress radiographs were taken to evaluate knee stability. Results: Significant (p\0.05) improvements were observed in the postoperative Lysholm, IKDC-s, and Tegner scores compared with preoperatively. The IKDC objective subscores (lateral joint opening at 20_______________of knee extension, external rotation at 30_______________and 90_______________, and the reverse pivot-shift test) had improved significantly at the time of the final 40.9 ± 13.7-month follow-up.Lateralcompartment opening on the varus stress radiographs had decreased significantly in the postoperative period. However, there was still a significant difference compared with the uninjured knee. There was no significant improvement in the IKDC-s, Lysholm, or Tegner scores between the nine patients with isolated PLC injuries and twelve with multiligament injuries. Conclusions: Significant improvement in the objective knee stability scores and clinical outcomes with anatomical reconstruction showed that this technique can be used to treat patients with chronic PLC injured knees. However, longer-term multicentre studies and studies with larger groups comparing multiple techniques are required to determine the best treatment method for PLC injuries.
Mobilisation of Joint-resident Mesenchymal Stromal Cells for Articular Cartilage Regeneration
Authors: Khan Alam Khalil , Baboolal Thomas , Wall Owen , Jone Elena , Mcgonagle Dennis 
Published: March 2017

Background and Objectives: Microfracture is a recognized procedure used to treat isolated cartilage injuries or defects, in which bone marrow mesenchymal stromal cells (BM-MSCs) are thought to migrate into the resulting blood clot, leading to subsequent cartilage repair via fibrocartilage formation. The discovery of MSCs in the synovium and synovial fluid (SF) provides a potential mechanism for repairing cartilage from the top down via their migration and homing to the microfracture site, however SF-MSCs low in number and usually lost with joint irrigation. The purpose of this work was threefold; first to test the hypothesis that SF-MSCs can be replaced, and also their numbers further increased by synovial agitation, second that these cells were capable of rapid adhesion to clots and third that the clot composition improve MSC migration. Materials-Methods: Ex-vivo mechanical agitation of human superficial synovium and in vivo intra-operative agitation of synovium in patients undergoing arthroscopy were performed using a Cytology brush and custom designed Synovial brush. Colony-forming unit-fibroblast (CFU-F) assay was performed to quantify released MSCs. Adhesion to clots was studied by comparing Platelet Rich Plasma (PRP), Whole Blood (WB) and Fibrin Glue (FG). Migration studies were performed using passage 2-4 synovial MSCs in trans-well migration assay. MSC migration, over a five hour period, was compared between PRP and pooled human Platelet Lysate (hPL). Results: Ex-vivo mechanical agitating of the synovium with the cytology brush compared to irrigation alone increased MSC number 2.7-fold (n=10, p=0.002). Irrigation during arthroscopy was seen to effectively remove the majority of CFU-Fs for the synovial fluid. Use of a custom designed synovial brush, compared to the cytology brush resulted in a median 65-fold increase in the number of CFU-Fs (n=8, p=0.0148). Trilineage differentiation of released synovial MSCs was at least comparable to donor match synovial fluid MSCs. These MSCs adhered to clots within 30 minutes with no difference seen between clot compositions. Released synovial MSCs demonstrated a trend for a better migration towards hPL compared to PRP. Conclusions: Existing surgical procedures wash away SF-MSCs. Using a novel brushing technique and a custom designed synovial brush, synovial MSCs can be mechanically released in vivo, and these cells were capable of migration and rapid adhesion to clots. Collectively these findings aid in the rapid replenishment of endogenous minimally manipulated MSCs, and provide a one-stage procedure combining synovial brushing with microfracture, as a strategy for cost effective joint repair.
Portal-site tract delayed closure in knee arthroscopy
Authors: Acar Nihat , Karaarslan Ahmet Adnan 
Published: March 2017

Objectives: knee arthroscopy done usually through two punctures (anteromedial and anterolateral). We aimed to record the impact of delayed tract closure on the post-operative sub-acute and chronic anterior knee pain. Design: Ultrasonography was used to evaluate the healing pattern of portal-site tracts. Setting and Participants: 104 operated patients, followed up for one year. Puncture wounds were divided into two groups, (1) anteromedial group and (2) anterolateral group. Each group contains 104 portal-site tract. Main Outcome Measures: VAS was used to measure pain related to delayed tract healing and its association with the post-operative sub-acute and chronic knee pain. Results: Anteromedial and anterolateral tracts average total healing time was (47 days, 28 days) respectively. The median VAS of anteromedial tract after 2 weeks, one month, three months, six months and one year was (8.2, 6.3, 4, 1.9, 0.6) respectively, and for the anterolateral tract was (7.4, 5.5, 2.8, 1.2, 0.2) respectively. A statistical significance was detected between the two groups at the first and third months with P values 0.042 and 0.0035 respectively. Conclusions: Anteromedial tracts closed later than anterolateral tracts. Both portal-site tracts delayed closure is a potential for post-operative sub-acute and chronic anterior knee pain after arthroscopic surgery. [Figure: see text][Figure: see text]
Consistency Between Posterior Condylar Axis (+3˚ external rotation) Line and Clinical Transepicondylar Axis Line in Primary Total Knee Arthroplasty
Authors: Taşdemir Zeki , Çevik Hüseyin Bilgehan , Elmalı Nurzat , Baysal Özgür 
Published: March 2017

Objectives: Purpose of this study is to as certain consistency between posterior condylar axis (PCA) + 3˚ external rotation line and clinical transepicondylar axis (cTEA) line in primary total knee arthroplasty cases. Materials-Methods: During surgery, following distal femoral cut PCA +3 degree external rotation line and cTEA line drawn on the distal femoral cutting surface by ruler and pencil. The both lines on distal femur were recorded by digital camera and relationship between lines was ascertained in reference to PCA +3 degree external rotation [parallel (P), Internal rotation (IR) and External Rotation (ER)]. Results: 9 knees of 9 patients [1 men, 8 women; average age 67 (59-80 age)] were constituted the study group. Evaluation results of the photographs revealed that clinical TEA line in comparison PCA +3 degrees external rotation line was ER in 9 knees (100%) whose mean angles 2.7˚ (1-6) and detected external roation with mean angle 4.7˚ (2-7) in 9 knees. Conclusion:: For determination of FC rotation in surgery setting, different results between cTEA and PCA + 3 degrees techniques possibly may due to disadvantages of techniques and anatomic variation of distal femur. Thus, using both techniques for check each other’s results seems unsafe. In custom made prosthesis, which can be done in the future it will be measured by CT. Keywords: Total knee arthroplasty, femoral component, rotational alignment, femoral transepicondylar axis, posterior condylar axis
Treatment and Outcomes of Reverse Shoulder Arthroplasty Dislocations
Authors: Chalmers Brian P , Wagner Eric R , Sperling John W , Cofield Robert H , Sanchez-Sotelo Joaquin 
Published: March 2017

Background Dislocation is a challenging complication after reverse shoulder arthroplasty (RSA). We sought to evaluate the outcome of nonoperative and operative management of the dislocation after primary and revision RSA. Methods Between 2006 and 2013, dislocation occurred in 12/1081 primary RSAs (1.1%) and 15/342 revision RSAs (4.4%). Seventeen (69%) shoulders dislocated within 3 months of surgery. Ten (68%) patients underwent revision RSA for prosthetic instability. Mean age was 69 years, and mean follow-up after index RSA was 4 years. Results Closed reduction and bracing achieved a stable shoulder in 60% (3/5 patients) after primary and 20% (1/5 patients) after revision RSA dislocation. Operative management achieved a stable shoulder in 88% (7/8 patients) of primary and 64% (7/11 patients) of revision RSAs ( P = .40). Overall, 9 shoulders (33%) had persistent instability at the final follow-up: 2/12 (17%) primaries versus 7/15 (47%) revisions ( P = .08). Preoperative prosthetic instability was the main risk factor for chronic instability in the revision cohort ( P = .02). Worse functional outcomes were associated with the dislocation of a revision RSA ( P = .02). Conclusion After primary RSA dislocations, closed reduction is successful in half, while revision surgery is successful in 85% of cases. Conversely, closed reduction of a dislocated revision RSA is rarely successful, while revision surgery is successful 65% of the time. Every attempt should be made to achieve stability at the time of primary and revision RSA, since reduction or revision surgery does not guarantee the restoring stability.
Diabetic polyneuropathy, sensory neurons, nuclear structure and spliceosome alterations: a role for CWC22
Authors: Kobayashi Masaki , Chandrasekhar Ambika , Cheng Chu , Martinez Jose A. , Ng Hilarie , de la Hoz Cristiane , Zochodne Douglas W. 
Published: March 2017

ABSTRACT
Unique deficits in the function of adult sensory neurons as part of their early neurodegeneration might account for progressive polyneuropathy during chronic diabetes mellitus. Here, we provide structural and functional evidence for aberrant pre-mRNA splicing in a chronic type 1 model of experimental diabetic polyneuropathy (DPN). Cajal bodies (CBs), unique nuclear substructures involved in RNA splicing, increased in number in diabetic sensory neurons, but their expected colocalization with survival motor neuron (SMN) proteins was reduced – a mislocalization described in motor neurons of spinal muscular atrophy. Small nuclear ribonucleoprotein particles (snRNPs), also participants in the spliceosome, had abnormal multiple nuclear foci unassociated with CBs, and their associated snRNAs were reduced. CWC22, a key spliceosome protein, was aberrantly upregulated in diabetic dorsal root ganglia (DRG), and impaired neuronal function. CWC22 attenuated sensory neuron plasticity, with knockdown in vitro enhancing their neurite outgrowth. Further, axonal delivery of CWC22 siRNA unilaterally to locally knock down the aberrant protein in diabetic nerves improved aspects of sensory function in diabetic mice. Collectively, our findings identify subtle but significant alterations in spliceosome structure and function, including dysregulated CBs and CWC22 overexpression, in diabetic sensory neurons that offer new ideas regarding diabetic sensory neurodegeneration in polyneuropathy.
Morphology Change from Nanotube to Vesicle and Monolayer/Bilayer Alteration by Amphiphilic Block Polypeptides Having Aromatic Groups at C Terminal
Authors: Kim Cheol Joo , Kurauchi Saki , Uebayashi Tsuguaki , Fujisaki Ai , Kimura Shunsaku 
Published: March 2017

Abstract
Various amphiphilic block polypeptides having aromatic groups at the C terminal of a Leu-based hydrophobic helical block, poly(sarcosine)-b-(l-Leu-Aib)6-ethylcarbazole, poly(sarcosine)-b-(d-Leu-Aib)6-naphthalimide, and poly(sarcosine)-b-(d-Leu-Aib)6-porphyrin, were synthesized and self-assembled in water. Molecular assemblies of distorted sheet, saddle-like sheet, and micelle were identified, which were different from the curved sheet of poly(sarcosine)-b-(l-Leu-Aib)6 without any aromatic groups, indicating that the attachment of the aromatic groups to the C terminal significantly influenced the morphology. Upon heating at 90 °C, vesicles were generated with the three amphiphilic polypeptides with aromatic groups as opposed to the nanotubes of poly(sarcosine)-b-(l-Leu-Aib)6. The precise observations of these vesicles by AFM revealed formation of monolayer for poly(sarcosine)-b-(l-Leu-Aib)6-ethylcarbazole and bilayers for poly(sarcosine)-b-(d-Leu-Aib)6-naphthalimide and poly(sarcosine)-b-(d-Leu-Aib)6-porphyrin. Attachment of aromatic groups at the C terminal therefore influences morphology and monolayer/bilayer alteration in accordance with the type of aromatic groups.
Studying of Foreign Languages with the Enlarged Number of Lessons in Non-state Educational Centres of Russia: Historical Experience and the Present
Authors: Карасева  , Karaseva T. 
Published: March 2017

The article is devoted to the formation and practical activities of non-state
schools of general education with thorough study of foreign languages
in Russia in 1990s–2000s. By the example of the «International English
School» and of some other educational centres, the author shows that the
linguistic education is one of the most acclaimed and long-term educational
trends in non-state education.
On the issue of word-order in Modern French sentence syntax
Authors: Газилов Магомед , Gazilov Magomed 
Published: March 2017

The article summarises the author’s research into one of the most challenging and relevant issues of the theory of the French Language, namely, the in-sentence position distribution of secondary parts of the sentence in Modern French.
The position of secondary parts of the sentence is determined by a multitude of factors, such as, for example, the stylistic colouring, the structural type of a sentence, the syntactical function performed by a secondary part and its morphological characteristics. The concept of position distribution of parts of the sentence, in its turn, has a certain bearing on the concept of a detached construction, which validates any change in position distribution within a sentence. Acquiring and developing syntax-interpretation and position-distribution skills are an important requisite for a French language learner’s success.
The long-term clinical and radiological outcomes in patients who suffer recurrent injuries to the anterior cruciate ligament after reconstruction
Authors: Ahmed I. , Salmon L. , Roe J. , Pinczewski L. 
Published: March 2017

Aims The aim of this study was to investigate the long-term clinical and radiological outcome of patients who suffer recurrent injuries to the anterior cruciate ligament (ACL) after reconstruction and require revision surgery. Patients and Methods From a consecutive series of 200 patients who underwent primary reconstruction following rupture of the ACL, we identified 36 who sustained a further rupture, 29 of whom underwent revision surgery. Patients were reviewed prospectively at one, two, seven, 15 and about 20 years after their original surgery. Primary outcome measures were the number of further ruptures, the posterior tibial slope (PTS), and functional and radiological outcomes. These were compared with a gender and age matched cohort of patients who underwent primary ACL reconstruction only. Results At a mean follow-up of 18.3 years (14.3 to 20.2), 29 patients had undergone revision surgery and within this revision group 11 had sustained more than three ruptures of the ACL (3 to 6). The mean age at the time of revision reconstruction was 26.4 years (14 to 54). The mean PTS was significantly higher in those patients who suffered a further injury to the ACL (11°) compared with the control group (9°) (p < 0.001). The mean PTS in those patients who sustained more than three ruptures was 12°. Conclusion Patients who suffer recurrent injuries to the ACL after reconstruction have poorer functional and radiological outcomes than those who suffer a single injury. The causes of further injury are likely to be multifactorial but an increased PTS appears to have a significant association with recurrent ACL injuries. Cite this article: Bone Joint J 2017;99-B:337–43.
The influence of cartilage thickness at the sigmoid notch on inclination at the distal radioulnar joint
Authors: Ross M. , Wiemann M. , Peters S. E. , Benson R. , Couzens G. B. 
Published: March 2017

Aims The aims of this study were: firstly, to investigate the influence of the thickness of cartilage at the sigmoid notch on the inclination of the distal radioulnar joint (DRUJ), and secondly, to compare the sensitivity and specificity of MRI with plain radiographs for the assessment of the inclination of the articular surface of the DRUJ in the coronal plane. Patients and Methods Contemporaneous MRI images and radiographs of 100 wrists from 98 asymptomatic patients (mean age 43 years, (16 to 67); 52 male, 53%) with no history of a fracture involving the wrist or surgery to the wrist, were reviewed. The thickness of the cartilage at the sigmoid notch, inclination of the DRUJ and Tolat Type of each DRUJ were determined. Results The assessment using MRI scans and cortical bone correlated well with radiographs, with a kappa value of 0.83. The mean difference between the inclination using the cortex and cartilage on MRI scans was 12°, leading to a change of Tolat type of inclination in 66% of wrists. No reverse oblique (Type 3) inclinations were found when using the cartilage to assess inclination. Conclusion These data revealed that when measuring the inclination of the DRUJ using cartilage, reverse oblique inclinations might not exist. The data suggest that performing an ulna shortening osteotomy might be reasonable even in distal radioulnar joints where the plain radiographic appearance suggests an unfavourable reverse oblique inclination in the coronal plane. We recommend using MRI to validate radiographs in those that appear to be reverse oblique (Tolat Type 3), as the true inclination might be different, thereby removing one possible contraindication to ulnar shortening. Cite this article: Bone Joint J 2017;99-B:369–75.
Bone penetration of intravenous flucloxacillin and gentamicin as antibiotic prophylaxis during total hip and knee arthroplasty
Authors: Torkington M. S. , Davison M. J. , Wheelwright E. F. , Jenkins P. J. , Anthony I. , Lovering A. M. , Blyth M. , Jones B. 
Published: March 2017

Aims To investigate the bone penetration of intravenous antibiotic prophylaxis with flucloxacillin and gentamicin during hip and knee arthroplasty, and their efficacy against Staphylococcus (S.) aureus and S. epidermidis. Patients and Methods Bone samples from the femoral head, neck and acetabulum were collected from 18 patients undergoing total hip arthroplasty (THA) and from the femur and tibia in 21 patients during total knee arthroplasty (TKA). The concentration of both antibiotics in the samples was analysed using high performance liquid chromatography. Penetration was expressed as a percentage of venous blood concentration. The efficacy against common infecting organisms was measured against both the minimum inhibitory concentration 50, and the more stringent epidemiological cutoff value for resistance (ECOFF). Results The bone penetration of gentamicin was higher than flucloxacillin. Relative to ECOFF, flucloxacillin concentrations were effective against S. aureus and S. epidermidis in all THAs and 20 (95%) TKAs. Gentamicin concentrations were effective against S. epidermidis in all bone samples. Gentamicin was effective against S. aureus in 11 (61.1%) femoral neck samples in THA. Effective concentrations of gentamicin against S. aureus were only achieved in four (19%) femoral and six (29%) tibial samples in TKA. Conclusion Flucloxacillin and gentamicin were found to penetrate bone during THA and TKA. Gentamicin was effective against S. epidermidis in both THA and TKA, while levels were subtherapeutic against S. aureus in most TKAs. Bone penetration of both antibiotics was less in TKA than THA, and may relate to the use of a tourniquet. Using this antibiotic combination, effective cover against the two common infective organisms was achieved in all THAs and all but one TKA. Cite this article: Bone Joint J 2017;99-B:358–64.