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| 1 | Treatment of acute periprosthetic infections with prosthesis retention: Review of current concepts显示文摘Periprosthetic joint infection(PJI) is a devastating complication after total joint arthroplasty, occurring in approximately 1%-2% of all cases. With growing populations and increasing age, PJI will have a growing effect on health care costs. Many risk factors have been identified that increase the risk of developing PJI, including obesity, immune system deficiencies, malignancy, previous surgery of the same joint and longer operating time. Acute PJI occurs either postoperatively(4 wk to 3 mo after initial arthroplasty, depending on the classification system), or via hematogenous spreading after a period in which the prosthesis had functioned properly. Diagnosis and the choice of treatment are the cornerstones to success. Although different definitions for PJI have been used in the past, most are more or less similar and include the presence of a sinus tract, blood infection values, synovial white blood cell count, signs of infection on histopathological analysis and one ormore positive culture results. Debridement, antibiotics and implant retention(DAIR) is the primary treatment for acute PJI, and should be performed as soon as possible after the development of symptoms. Success rates differ, but most studies report success rates of around 60%-80%. Whether single or multiple debridement procedures are more successful remains unclear. The use of local antibiotics in addition to the administration of systemic antibiotic agents is also subject to debate, and its pro's and con's should be carefully considered. Systemic treatment, based on culture results, is of importance for all PJI treatments. Additionally, rifampin should be given in Staphylococcal PJIs, unless all foreign material is removed. The most important factors contributing to treatment failure are longer duration of symptoms, a longer time after initial arthroplasty, the need for more debridement procedures, the retention of exchangeable components, and PJI caused by Staphylococcus(aureus or coagulase negative). If DAIR treatment is unsuccessful, the following treatment option should be based on the patient health status and his or her expectations. For the best functional outcome, one- or two-stage revision should be performed after DAIR failure. In conclusion, DAIR is the obvious choice for treatment of acute PJI, with good success rates in selected patients. | Jesse WP Kuiper Robin Tjeenk Willink Dirk Jan F Moojen Michel PJ van den Bekerom Sascha Colen | 2014 | World Journal of Orthopedics2014，5，5： | 12 |
| 2 | Diagnosing syndesmotic instability in ankle fractures显示文摘The precise diagnosis of distal tibiofibular syndesmotic ligament injury is challenging and a distinction should be made between syndesmotic ligament disruption and real syndesmotic instability.This article summarizes the available evidence in the light of the author’s opinion.Pre-operative radiographic assessment,standard radiographs,computed tomography scanning and magnetic resonance imaging are of limited value in detecting syndesmotic instability in acute ankle fractures but can be helpful in planning.Intra-operative stress testing,in the sagittal,coronal or exorotation direction,is more reliable in the diagnosis of syndesmotic instability of rotational ankle fractures.The Hook or Cotton test is more reliable than the exorotation stress test.The lateral view is more reliable than the AP mortise view because of the larger displacement in this direction.When the Hook test is used the force should be applied in the sagittal direction.A force of 100 N applied to the fibula seems to be appropriate.In the case of an unstable joint requiring syndesmotic stabilisation,the tibiofibular clear space would exceed 5 mm on the lateral stress test.When the surgeon is able to perform an ankle arthroscopy this technique is useful to detect syndesmotic injury and can guide anatomic reduction of the syndesmosis.Many guidelines formulated in this article are based on biomechanical and cadaveric studies and clinical correlation has to be established. | Michel PJ van den Bekerom | 2011 | World Journal of Orthopedics2011，2，7： | 10 |
| 3 | Current concepts in the management of radial head fractures显示文摘Fracture of the radial head is a common injury. Over the last decades, the radial head is increasingly recognized as an important stabilizer of the elbow. In order to maintain stability of the injured elbow, goals of treatment of radial head fractures have become more and more towards restoring function and stability of the elbow. As treatment strategies have changed over the years, with an increasing amount of literature on this subject, the purpose of this article was to provide an overview of current concepts of the management of radial head fractures. | Iza?k F Kodde Laurens Kaas Mark Flipsen Michel PJ van den Bekerom Denise Eygendaal | 2015 | World Journal of Orthopedics2015，6，11： | 9 |
| 4 | Role of decision aids in orthopaedic surgery显示文摘Medical treatment of patients inherently entails the risk of undesired complication or side effects. It is essential to inform the patient about the expected outcomes, but also the possible undesired outcomes. The patients preference and values regarding the potential outcomes should be involved in the decision making process. Even though many orthopaedic surgeons are positive towards shared decision-making, it is minimally introduced in the orthopaedic daily practice and decision-making is still mostly physician based. Decision aids are designed to support the physician and patient in the shareddecision-making process. By using decision aids, patients can learn more about their condition and treatment options in advance to the decision-making. This will reduce decisional conflict and improve participation and satisfaction. | Isha A ten Have Michel PJ van den Bekerom Derek FP van Deurzen Michel GJS Hageman | 2015 | World Journal of Orthopedics2015，6，11： | 1 |
| 5 | Surgical stabilisation of the proximal tibiofibular joint using temporary fixation:a technical note 显示文摘 | van den Bekerom Michel PJ Weir Adam van der Flier Rudolf E | 2004 | Acta Orthop Belg2004，6，： | 1 |
| 6 | Corticosteroid injection alone vs additional physiotherapy treatment in early stage frozen shoulders显示文摘AIM To investigate the additional value of physiotherapy after a corticosteroid injection in stage one or two idiopathic frozen shoulders(FSs).METHODS A two center, randomized controlled trial was done. Patients with a painful early stage idiopathic FS were eligible for inclusion. After written consent, patients were randomly allocated into two groups. All patients received an ultrasound-guided intra-articular corticosteroid injection. One group underwent additional physiotherapy treatment(PT) and the other group did not(non-PT). The primary outcome measure was the Shoulder Painand Disability Index(SPADI). Secondary outcomes were pain(numeric pain rating scale), range of motion(ROM), quality of life(RAND-36 score), and patient satisfaction. Follow-up was scheduled after 6, 12 and 26 wk.RESULTS Twenty-one patients were included, 11 patients in the non-PT and ten in the PT group, with a mean age of 52 years. Both treatment groups showed a significant improvement at 26 wk for SPADI score(non-PT: P = 0.05, PT: P = 0.03). At the 6 wk follow-up, median SPADI score was significant decreased in the PT group(14 IQR: 6-38) vs the non-PT group(63 IQR: 45-76)(P = 0.01). Pain decreased significantly in both groups but no differences were observed between both treatment groups at any time point, except for night pain at 6 wk in favor of the PT group(P = 0.02). Significant differences in all three ROM directions were observed after 6 wk in favor of the PT group(P ≤ 0.02 for all directions). A significantly greater improvement in abduction(P = 0.03) and external rotation(P = 0.04) was also present in favor of the PT group after 12 wk. RAND-36 scores showed no significant differences in health-related quality of life at all follow-up moments. At 26 wk, both groups did not differ significantly with respect to any of the outcome parameters. No complications were reported in both groups.CONCLUSION Additional physiotherapy after corticosteroid injection improves ROM and functional limitations in early-stage FSs up to the first three months. | Tim Kraal Inger Sierevelt Derek van Deurzen Michel PJ van den Bekerom Lijkele Beimers | 2018 | World Journal of Orthopedics2018，9，9： | 1 |
| 7 | Tips to avoid nerve injury in elbow arthroscopy显示文摘Elbow arthroscopy is a technical challenging surgical procedure because of close proximity of neurovascular structures and the limited articular working space. With the rising number of elbow arthroscopies being performed nowadays due to an increasing number of surgeons performing this procedure and a broader range of indications, a rise in complications is foreseen. With this editorial we hope to create awareness of possible complications of elbow arthroscopy, particularly nerve injuries, and provide a guideline to avoid complications during elbow arthroscopy. | Nick FJ Hilgersom Luke S Oh Mark Flipsen Denise Eygendaal Michel PJ van den Bekerom | 2017 | World Journal of Orthopedics2017，8，2： | 0 |
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