10 research outputs found
Evaluation of microfracture of traumatic chondral injuries to the knee in professional football and rugby players
Get PDF<p>Abstract</p> <p>Background</p> <p>Traumatic chondral lesions of the knee are common in football and rugby players. The diagnosis is often confirmed by arthroscopy which can be therapeutic by performing microfracture. Prospective information about the clinical results after microfracture is still limited.</p> <p>Aim</p> <p>To evaluate the short-term outcome of microfractured lesions in professional football ad rugby players in terms of healing and ability to return to play.</p> <p>Methods</p> <p>Twenty-four consecutive professional male players with isolated full-thickness articular cartilage defects on weight-bearing surface of femoral condyles were treated with microfracture. Clinical assessment of healing was done at three, six, 12 and at 18 months by using modified Cincinnati subjective and objective functional scoring. All 24 subjects were periodically scanned by 3-Tesla MRI on the day of the clinical evaluations and scored by the Henderson MRI classification for cartilage healing. A second look arthroscopy was carried out in 10 players five to seven months after surgery to evaluate lesion healing by using ICRS scoring system. This was done due to presence of discrepancy between a "normal" MRI and persistent clinical symptoms.</p> <p>Results</p> <p>This study showed that 83.3% of players' resume full training between five to seven months (mean: 6.2) after microfracture of full-thickness chondral lesions of weight-bearing surface of the knee. Function and MRI knee scores of the 24 subjects gradually improved over 18 months, and showed good correlation in assessing healing after microfracture at six, 12 and 18 months (r<sup>2 </sup>= 0.993, 0.986 and 0.993, respectively) however, the second look arthroscopy score proved to have stronger strength of association with function score than MRI score.</p> <p>Conclusion</p> <p>We confirmed that microfracture is a safe and effective procedure in treating isolated traumatic chondral lesions of the load-bearing areas of the knee. Healing as defined by subjective symptoms and evaluated by MRI and a modified knee function score occurred between 5 to 7 months in most cases, which is a reasonable absence period for the majority of players to resume their normal sports activity without risking contracts and careers. MRI correlated well with the functional knee score, but neither of these methods were totally reliable in confirming healing at the defect site. Arthroscopic probing is therefore still the gold standard in our view. From a strict scientific stand point an untreated control group would be valuable to demonstrate that microfracture does not just mirror the natural course of healing.</p
The Construction of a Monoclonal Diagnostic System for the Field Detection of V. cholerae
Get PDFCholera is an acute diarrheal disease that is characterized by massive loss of fluids and electrolytes. If it remains untreated, in its most severe form it may result in death. The causative agent is Vibrio cholerae, which was first described by Robert Koch (1884). The disease is contracted by the ingestion of water or food contaminated by the excreta of persons harbouring the bacilli. Since it is exquisitely sensitive to gastric acid, at least 100 million vibrios are required for infection in a reasonably healthy person, but in a malnourished victim or someone with no gastric acidity, 10,000 to 1 million vibrios can produce disease. The human is the only host of V. cholerae (Smith, 1985)
The importance of early arthroscopy in athletes with painful cartilage lesions of the ankle: a prospective study of 61 consecutive cases
Get PDFBACKGROUND
Ankle sprains are common in sports and can sometimes result in a persistent pain condition.
PURPOSE
Primarily to evaluate clinical symptoms, signs, diagnostics and outcomes of surgery for symptomatic chondral injuries of the talo crural joint in athletes. Secondly, in applicable cases, to evaluate the accuracy of MRI in detecting these injuries. Type of study: Prospective consecutive series.
METHODS
Over around 4 years we studied 61 consecutive athletes with symptomatic chondral lesions to the talocrural joint causing persistent exertion ankle pain.
RESULTS
43% were professional full time athletes and 67% were semi-professional, elite or amateur athletes, main sports being soccer (49%) and rugby (14%). The main subjective complaint was exertion ankle pain (93%). Effusion (75%) and joint line tenderness on palpation (92%) were the most common clinical findings. The duration from injury to arthroscopy for 58/61 cases was 7 months (5.7–7.9). 3/61 cases were referred within 3 weeks from injury. There were in total 75 cartilage lesions. Of these, 52 were located on the Talus dome, 17 on the medial malleolus and 6 on the Tibia plafond. Of the Talus dome injuries 18 were anteromedial, 14 anterolateral, 9 posteromedial, 3 posterolateral and 8 affecting mid talus. 50% were grade 4 lesions, 13.3% grade 3, 16.7% grade 2 and 20% grade 1. MRI had been performed pre operatively in 26/61 (39%) and 59% of these had been interpreted as normal. Detection rate of cartilage lesions was only 19%, but subchondral oedema was present in 55%. At clinical follow up average 24 months after surgery (10–48 months), 73% were playing at pre-injury level. The average return to that level of sports after surgery was 16 weeks (3–32 weeks). However 43% still suffered minor symptoms.
CONCLUSION
Arthroscopy should be considered early when an athlete presents with exertion ankle pain, effusion and joint line tenderness on palpation after a previous sprain. Conventional MRI is not reliable for detecting isolated cartilage lesions, but the presence of subchondral oedema should raise such suspicion
Large expert-curated database for benchmarking document similarity detection in biomedical literature search
Get PDFDocument recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe
Traumatic Chondral Lesions of the Knee in Athletes with Emphasis on Arthroscopy, MRI, and Knee Function
No full textBackground: Traumatic chondral lesions of the knee are common in football and rugby players, The diagnosis is often confirmed by arthroscopy, considered appropriate because of persistent pain and effusion. The natural course of these injuries is not well known. Clinical diagnosis is difficult and MRI is not always reliable. Aims: 1. To introduce a simplified arthroscopic mapping system of the weight-bearing surfaces of the knee which can be used to describe the location of these chondral lesions. 2. To correlate the location and severity of these lesions with a novel knee function score designe~ to reflect the demands of football and rugby. 3. To assess the accuracy of different MRI sequences in diagnosing chondral lesions using the arthroscopic mapping system as a standard. 4. To evaluate the short-term functional outcome of microfractured lesions using MRI and function scores. Methods: Forty two consecutive football and rugby players with traumatic isolated chondral lesions observed at arthroscopy were included after appropriate consent. Lesion size and grade were recorded with the mapping system. All subjects were scanned two to three weeks after surgery using a 3-Tesla MRI. At eight to 12 weeks from surgery they were tested with the functional knee score. Twenty four out of 42 subjects with grade III IV lesions underwent microfracture at the time of arthroscopy. They were assessed at 3, 6, 12 and 18 months by functional knee score and MRI. A second look arthroscopy was carried out in 10 players five to seven months after surgery to evaluate lesion healing because there was discrepancy between. a 'normal' MRI and persistent clinical symptoms. Results: Fifty five lesions on weight-bearing surfaces were found in the 42 subjects. The average size of the lesion was 197 square mm. Pain, effusion, tenderness on palpation and positive compression rotation test were the predominant symptoms and signs. The medial femoral condyle (MFC) was affected most with 36 (65 %) of the lesions. the lesions were concentrated in the B areas (p < 0.05). Grade IV lesions were the most common with 26 lesions (47.3 %). These lesions were concentrated in the B areas (p < 0.05). Cartilage specific sequences (CSS) showed a sensitivity of 89 percent and specificity of 98 percent to identify the chondral lesions. Lesion location and grade determined by MRI were comparable to arthroscopy, but size was underestimated by MRI (p < 0.05). Both the functional knee score and MRI showed good correlation in assessing healing after microfracture at six, 12 and 18 months (r2 =0.993,0.986 and 0.993, respectively). Conclusion: The distribution of the traumatic chondral lesions over the weight-bearing surfaces of the knee is unequal, and neither location nor grade predict functional outcome. Cartilage specific sequences have relatively high sensitivity but are not reliable enough to replace arthroscopy in diagnosing cases with typical symptoms and signs. Microfracture shows excellent short term out-comes. Both the functional knee score and MRI are reliable enough on average to confirm healing at the defect site, and a second look arthroscopy may be required in some cases.EThOS - Electronic Theses Online ServiceGBUnited Kingdo
Traumatic Chondral Lesions of the Knee in Athletes with Emphasis on Arthroscopy, MRI, and Knee Function
No full textBackground: Traumatic chondral lesions of the knee are common in football and rugby players, The diagnosis is often confirmed by arthroscopy, considered appropriate because of persistent pain and effusion. The natural course of these injuries is not well known. Clinical diagnosis is difficult and MRI is not always reliable. Aims: 1. To introduce a simplified arthroscopic mapping system of the weight-bearing surfaces of the knee which can be used to describe the location of these chondral lesions. 2. To correlate the location and severity of these lesions with a novel knee function score designe~ to reflect the demands of football and rugby. 3. To assess the accuracy of different MRI sequences in diagnosing chondral lesions using the arthroscopic mapping system as a standard. 4. To evaluate the short-term functional outcome of microfractured lesions using MRI and function scores. Methods: Forty two consecutive football and rugby players with traumatic isolated chondral lesions observed at arthroscopy were included after appropriate consent. Lesion size and grade were recorded with the mapping system. All subjects were scanned two to three weeks after surgery using a 3-Tesla MRI. At eight to 12 weeks from surgery they were tested with the functional knee score. Twenty four out of 42 subjects with grade III IV lesions underwent microfracture at the time of arthroscopy. They were assessed at 3, 6, 12 and 18 months by functional knee score and MRI. A second look arthroscopy was carried out in 10 players five to seven months after surgery to evaluate lesion healing because there was discrepancy between. a 'normal' MRI and persistent clinical symptoms. Results: Fifty five lesions on weight-bearing surfaces were found in the 42 subjects. The average size of the lesion was 197 square mm. Pain, effusion, tenderness on palpation and positive compression rotation test were the predominant symptoms and signs. The medial femoral condyle (MFC) was affected most with 36 (65 %) of the lesions. the lesions were concentrated in the B areas (p < 0.05). Grade IV lesions were the most common with 26 lesions (47.3 %). These lesions were concentrated in the B areas (p < 0.05). Cartilage specific sequences (CSS) showed a sensitivity of 89 percent and specificity of 98 percent to identify the chondral lesions. Lesion location and grade determined by MRI were comparable to arthroscopy, but size was underestimated by MRI (p < 0.05). Both the functional knee score and MRI showed good correlation in assessing healing after microfracture at six, 12 and 18 months (r2 =0.993,0.986 and 0.993, respectively). Conclusion: The distribution of the traumatic chondral lesions over the weight-bearing surfaces of the knee is unequal, and neither location nor grade predict functional outcome. Cartilage specific sequences have relatively high sensitivity but are not reliable enough to replace arthroscopy in diagnosing cases with typical symptoms and signs. Microfracture shows excellent short term out-comes. Both the functional knee score and MRI are reliable enough on average to confirm healing at the defect site, and a second look arthroscopy may be required in some cases.EThOS - Electronic Theses Online ServiceGBUnited Kingdo
Large expert-curated database for benchmarking document similarity detection in biomedical literature search
No full textLarge expert-curated database for benchmarking document similarity detection in biomedical literature search
No full textDocument recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical science. © The Author(s) 2019. Published by Oxford University Press
