Page 7 - ISAKOS 2020 Newsletter Volume 2

Acromial Morphology Classifications Demonstrate Significant Correlation
Antonio Klasan, Domink Malcherczyk, Thomas Neri, Jascha Saul, Markus Dietmar Scoger, Thomas Jan Heyse, Bilal Forouk El-Zayat
Retrospective Diagnostic Study
Various classification systems for acromial morphology have been described in the literature. The purposes of this study were to determine whether there were correlations between different classifications in a large cohort and to establish whether there were differences according to age, side, and sex. The shoulder CT scans for 350 polytraumatized patients (232 males and 118 females ranging from 16 to 90 years of age) were retrospectively reviewed with regard to acromial slope, acromial type, lateral acromial angle (LAA), and acromial index. Analysis with use of the Pearson correlation coefficient demonstrated significant correlations between all classification systems. In addition, excellent correlations were noted for left-right comparisons of all measurements, sex showed no correlation to any of the measurements, and age was correlated with LAA and acromial type. These findings may aid the clinician in choosing which classification system to use when reporting on patients.
HAND AND WRIST
Novel Patient-Specific Visual Analogue Survey Following Collagenase Injection for Dupuytren Disease
Stephen Lyman, Jayme Kotsov, Chisa Hidaka, Quynh Tran, Naomi Roselaar, Norimasa Nakamura, Robert Hotchkiss
Prospective Cohort Study
Lyman et al. developed and validated an electronically administered patient-specific visual analogue survey (PVS) to evaluate changes in hand function after treatment with injectable collagenase clostridium histolyticum (CCH) in a study of 109 patients with Dupuytren contracture. The items in the PVS were authored and ranked in importance by the patients. Patients completed the PVS on the day of injection, on the day of manipulation, and at the time of the 30-day follow-up. For external validation, patients also completed standard patient-reported outcome measures (Overall Treatment Effects Scale and QuickDASH) and underwent physician assessment of contracture via goniometry and the table top test. Responses were highly individualized, with no single activity being chosen as important by more than 8% of patients; sports-related activities were mentioned most often (23%). The PVS was highly responsive to changes in patients’ conditions following CCH injection and was more responsive than the QuickDASH (effect size, 1.49 compared 0.50). Additionally, the PVS had no floor or ceiling effects, whereas the QuickDASH ceiling approached 20% post- injection. The PVS had excellent internal consistency and correlated strongly with the QuickDASH post-injection.
PVS scores were significantly higher for patients who reported improvement after injection than for those who reported no change. The test-retest reliability of the PVS was poor to fair, in part because patients were allowed to choose different activities at test and retest. However, among patients who rated the same activities at both intervals, test- retest reliability was good and was better than that of the QuickDASH. The authors concluded that the PVS is simple to administer and enables individualized assessment in a large number of patients. It is also readily adaptable for use in other diseases, particularly within musculoskeletal medicine.
LOWER EXTREMITY HIP
Practical Office Ultrasound for the Hip Surgeon
Ehud Rath, Zachary T. Sharfman, Eyal Amar
Current Concepts Review
In this Current Concepts Review, Rath et al. describe the advantages of ultrasound for the hip surgeon. Ultrasound imaging allows for real-time dynamic visualization of muscles, tendons, fascial planes, and joints. This modality enhances the sensitivity of physical examination for the localization of pathology, improves clinical diagnostic accuracy, improves the accuracy of targeted injections without the need for fluoroscopy, is economically affordable and portable, and does not expose the patient or provider to radiation. A thorough understanding of the anatomy and biomechanics of the hip and a working knowledge of both intra-articular and extra-articular hip pathologies is essential to optimizing the utility of this modality. Ultrasound-guided injections allow for real-time visualization of both the needle and soft tissue or intra-articular target and are superior to unguided hip injections. Improved patient care can be achieved through the skilled use of ultrasound by a hip surgeon, radiologist, or ultrasound technician with appropriate training.
KNEE
Biplanar Ascending Opening-Wedge HTO Increases Tibial Tubercle-Trochlear Groove Distance and Decreases Patellar Height
Alexandre Barbieri Mestriner, Jakob Ackermann, Gergo Merkely, Takahiro Ogura, Juan Pablo Zicaro, Andreas H. Gomoll
Retrospective Case Study
The purpose of this study was to assess the effect of biplanar ascending opening-wedge high tibial osteotomy (OWHTO) on the alignment of the knee extensor mechanism and patellar height with use of preoperative and postoperative MRI.
JISAKOS ARTICLE REVIEW
ISAKOS NEWSLETTER 2020: VOLUME II 5