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The Bone & Joint Journal
Vol. 96-B, Issue 6 | Pages 737 - 742
1 Jun 2014
Eggerding V van Kuijk KSR van Meer BL Bierma-Zeinstra SMA van Arkel ERA Reijman M Waarsing JH Meuffels DE

We have investigated whether shape of the knee can predict the clinical outcome of patients after an anterior cruciate ligament rupture. We used statistical shape modelling to measure the shape of the knee joint of 182 prospectively followed patients on lateral and Rosenberg view radiographs of the knee after a rupture of the anterior cruciate ligament. Subsequently, we associated knee shape with the International Knee Documentation Committee subjective score at two years follow-up. The mean age of patients was 31 years (21 to 51), the majority were male (n = 121) and treated operatively (n = 135). We found two modes (shape variations) that were significantly associated with the subjective score at two years: one for the operatively treated group (p = 0.002) and one for the non-operatively treated group (p = 0.003). Operatively treated patients who had higher subjective scores had a smaller intercondylar notch and a smaller width of the intercondylar eminence. Non-operatively treated patients who scored higher on the subjective score had a more pyramidal intercondylar notch as opposed to one that was more dome-shaped. We conclude that the shape of the femoral notch and the intercondylar eminence is predictive of clinical outcome two years after a rupture of the anterior cruciate ligament.

Cite this article: Bone Joint J 2014;96-B:737–42.


The Journal of Bone & Joint Surgery British Volume
Vol. 91-B, Issue 4 | Pages 504 - 510
1 Apr 2009
Henkus HE de Witte PB Nelissen RGHH Brand R van Arkel ERA

In a prospective randomised study we compared the results of arthroscopic subacromial bursectomy alone with debridement of the subacromial bursa followed by acromioplasty. A total of 57 patients with a mean age of 47 years (31 to 60) suffering from primary subacromial impingement without a rupture of the rotator cuff who had failed previous conservative treatment were entered into the trial. The type of acromion was classified according to Bigliani. Patients were assessed at follow-up using the Constant score, the simple shoulder test and visual analogue scores for pain and functional impairment. One patient was lost to follow-up.

At a mean follow-up of 2.5 years (1 to 5) both bursectomy and acromioplasty gave good clinical results. No statistically significant differences were found between the two treatments. The type of acromion and severity of symptoms had a greater influence on the clinical outcome than the type of treatment. As a result, we believe that primary subacromial impingement syndrome is largely an intrinsic degenerative condition rather than an extrinsic mechanical disorder.


The Journal of Bone & Joint Surgery British Volume
Vol. 84-B, Issue 2 | Pages 227 - 231
1 Mar 2002
van Arkel ERA de Boer HH

We describe a prospective survival analysis of 63 consecutive meniscal allografts transplanted into 57 patients. The lateral meniscus was transplanted in 34, the medial meniscus in 17, and both menisci (combined) in the same knee in six. For survival analysis we used persistent pain or mechanical damage as clinical criteria of failure. A total of 13 allografts failed (5 lateral, 7 medial, 1 medial and lateral).

A significant negative correlation (p = 0.003) was found between rupture of the anterior cruciate ligament (ACL) and successful meniscal transplantation. A significant difference (p = 0.004) in the clinical results was found between lateral and medial meniscal transplants.

The cumulative survival rate of the lateral, medial and combined allografts in the same knee, based on the life-table method and the Kaplan-Meier calculation, was 76%, 50% and 67%, respectively. The survival of medial meniscal allografts may improve when reconstruction of the ACL is carried out at the same time as meniscal transplantation in an ACL-deficient knee.