JTO
03 Mar 2021

JTO - March 2021

Volume 9 Issue 1

From the Executive Editor

So the New Year certainly started with a bang... not due to the fireworks that had all been cancelled but courtesy of the ‘New Variant’ of an ‘Old Foe’. We were straight back into the thick of things and recovery is only just starting but there are some green shoots of spring appearing and reasons to be cheerful.

And what do you do when the nights are still long and work is not quite what you would like it to be… perhaps relax, put your feet up, curl up on the sofa and peruse a magazine or indeed the JTO? Well, I think you should... this edition is a pot pourri of interesting bits and pieces for you to dip in and out of. Like any good magazine, this edition of the JTO has a travel section where we will take you abroad (something we are all sadly missing) to Malawi, and a reflection by John Cashman on what has been achieved there during his tenure and beyond (page 36). Reflecting is a little bit of a theme this issue with Andrea Sott writing about her experiences not only, of rising to the challenges of a Medical Director post but in COVID-19 times too and the knock on effects of the ‘casual comment’ both good and bad (page 24). However, if its reflection you are after, look no further than the excellent article by Alister Hart looking at Ronnie Furlong the man and his hip (page 20) and going even further back, Ian Stephen our BOA Archivist, reflects on the origins or our Association (page 18). Looking at that menu and the signatures on it, always gives me a slight shiver down my spine.

RCS portrait banner.png

 

We can’t spend all our time in the past though so the challenges of being a trainee and where you are going to be trained is a constant concern at present – but hopefully the words by Ran Wei and Rob Gregory will be reassuring. I will take this opportunity to remind you that the new curriculum starts in six months time and trainers as well as trainees must be ready – this will involve you learning new things!

I know orthopods and there is only so much relaxing we can take so, of course, this JTO covers research and academia too – particularly clinically relevant research via our research champions and Hunterian Professors. Andrew Price and colleagues would like us to remember ‘it’s all about the knee’ – the soft tissues anyway, if not the joint! I think it’s all about the kids – but perhaps that will be for a future edition!

2020-21 has seen us embrace ‘alternative’ media, so if reading the JTO cover to cover is more than your attention span can cope with, I suggest you have a look at the Transient Journal webpages (www.boa.ac.uk/T-JTO) where you will find podcasts on knitting and pieces on constructing dinosaurs; perhaps they are vying for inclusion in the indicative procedures section of our new curriculum? Or maybe not… maybe it’s just for fun and happiness and we are all in favour of that at the moment.

As we head into Spring, and the future looks brighter please remember – “Great opportunities to help others seldom come, but small ones surround us every day.”– Sally Koch

I hope you enjoy this JTO and if you have any ideas for future articles, please let me know.

Deborah Eastwood, Vice President Elect

 

Subspecialty Section

 

References

Society for Back Pain Research (SBPR) update

  1. Rustenburg CME, Snuggs JW, Emanuel KS, Thorpe A, Sammon C, Le Maitre CL, Smit TH. Modelling the catabolic environment of the moderately degenerated disc with a caprine ex vivo loaded disc culture system. Eur Cell Mater. 2020;40:21-37.
  2. Binch A, Snuggs J, Le Maitre CL. Immunohistochemical analysis of protein expression in formalin fixed paraffin embedded human intervertebral disc tissues. JOR Spine. 2020;3(3):e1098.
  3. Deane JA, Pavlova AV, Lim AKP, Gregory JS, Aspden RM, McGregor AH. Is intrinsic lumbar spine shape associated with lumbar disc degeneration? An exploratory study. BMC Musculoskelet Disord. 2020;21(1):433.
  4. Williamson E, Sanchez Santos MT, Morris A, Garrett A,Conway O, Boniface G, et al. The Prevalence of Back and Leg Pain and the Cross-sectional Association With Adverse Health Outcomes in Community Dwelling Older Adults in England. Spine (Phila Pa 1976). 2021;46(1):54-61.
  5. Roberts L, Osborn-Jenkins L. Delivering remote consultations: Talking the talk. Musculoskelet Sci Pract. 2020 [Epub ahead of print].
  6. Ryan C, Pope CJ, Roberts L. Why managing sciatica is difficult: patients’ experiences of an NHS sciatica pathway. A qualitative, interpretative study. BMJ Open. 2020;10:e037157.
  7. Shaheed CA, Machado GC, Underwood M. Drugs for chronic pain. Br J Gen Pract. 2020;70(701):576-7.
  8. Hallegraeff JM, Kan R, van Trijffel E, Reneman MF. State anxiety improves prediction of pain and pain-related disability after 12 weeks in patients with acute low back pain: a cohort study. J Physiother. 2020;66(1):39-44.
  9. Mannion AF, Mariaux F, Reitmeir R, Fekete TF, Haschtmann D, Loibl M, et al. Development of the "Core Yellow Flags Index" (CYFI) as a brief instrument for the assessment of key psychological factors in patients undergoing spine surgery. Eur Spine J. 2020;29(8):1935-52.
  10. Geraghty AWA, Roberts L, Hill J, Foster NE, Yardley L, Hat E, et al. Supporting self-management of low back pain with an internet intervention in primary care: a protocol for a randomised controlled trial of clinical and cost-effectiveness (SupportBack 2).  BMJ Open. 2020 10:e040543.

The posterior malleolar fracture – is the rule of a third or use of percentages an orthopaedic myth?

  1. Mason LW, Marlow WJ, Widnall J, Molloy AP. Pathoanatomy and Associated Injuries of Posterior Malleolus Fracture of the Ankle. Foot Ankle Int. 2017 Nov;38(11):1229-35.
  2. Bartonicek J, Rammelt S, Kostlivy K, Vanecek V, Klika D, Tresl I. Anatomy and classification of the posterior tibial fragment in ankle fractures. Arch Orthop Trauma Surg. 2015;135(4):505-16.
  3. Verhage SM, Hoogendoorn JM, Krijnen P, Schipper IB. When and how to operate the posterior malleolus fragment in trimalleolar fractures: a systematic literature review. Arch Orthop Trauma Surg. 2018;138(9):1213-22.
  4. White TO. In defence of the posterior malleolus. Bone Joint J. 2018;100-B(5):566-9.
  5. Nelson MC, Jensen NK. The treatment of trimalleolar fractures of the ankle. Surgery, Gynecology and Obstetrics. Surg Gynecol Obstet. 1940;71:509-14.
  6. Mandell J. Isolated fractures of the posterior tibial lip at the ankle as demonstrated by an additional projection, the “poor” lateral view. Radiology. 1971;101(2):319-22.
  7. Leung KH, Fang CX, Lau TW, Leung FK. Preoperative radiography versus computed tomography for surgical planning for ankle fractures. J Orthop Surg (Hong Kong). 2016;24(2):158-62.
  8. Black EM, Antoci V, Lee JT, Weaver MJ, Johnson AH, Susarla SM, et al. Role of preoperative computed tomography scans in operative planning for malleolar ankle fractures. Foot Ankle Int. 2013;34(5):697-704.
  9. Ferries JS, DeCoster TA, Firoozbakhsh KK, Garcia JF, Miller RA. Plain radiographic interpretation in trimalleolar ankle fractures poorly assesses posterior fragment size. J Orthop Trauma. 1994;8(4):328-31.
  10. Sheikh HQ, Mills EJ, McGregor-Riley JC, Chadwick C, Davies MB. The effect of computerised tomography on operative planning in posterior malleolus ankle fractures. Foot Ankle Surg. 2020;26(6):676-80.
  11. Meijer DT, de Muinck Keizer RJ, Doornberg JN, Sierevelt IN, Stufkens SA, Kerkhoffs GM, et al. Diagnostic Accuracy of 2-Dimensional Computed Tomography for Articular Involvement and Fracture Pattern of Posterior Malleolar Fractures. Foot Ankle Int. 2016;37(1):75-82.
  12. Meijer DT, Doornberg JN, Sierevelt IN, Mallee WH, van Dijk CN, Kerkhoffs GM, et al. Guesstimation of posterior malleolar fractures on lateral plain radiographs. Injury. 2015;46(10):2024-9.
  13. Buchler L, Tannast M, Bonel HM, Weber M. Reliability of radiologic assessment of the fracture anatomy at the posterior tibial plafond in malleolar fractures. J Orthop Trauma. 2009;23(3):208-12.
  14. Kumar A, Mishra P, Tandon A, Arora R, Chadha M. Effect of CT on Management Plan in Malleolar Ankle Fractures. Foot Ankle Int. 2018;39(1):59-66.
  15. Haraguchi N, Haruyama H, Toga H, Kato F. Pathoanatomy of Posterior Malleolar Fractures of the Ankle. J Bone  Joint Surg Am. 2006;88(5):1085-92.
  16. Mason LW, Marlow WJ, Widnall J, Molloy AP. Pathoanatomy and Associated Injuries of Posterior Malleolus Fracture of the Ankle. Foot Ankle Int. 2017;38(11):1229-35.
  17. Lambert LA, Falconer L, Mason L. Ankle stability in ankle fracture. J Clin Orthop Trauma. 2020;11(3):375-9.
  18. Haraguchi N, Armiger RS. Mechanism of posterior malleolar fracture of the ankle: A cadaveric study. OTA International. 2020;3(2):e060.
  19. Gardner MJ, Brodsky A, Briggs SM, Lorich DG, Nielson JH. Fixation of posterior malleolar fractures provides greater syndesmotic stability. Clin Orthop Rel Res. 2006(447):165-71.
  20. Baumbach SF, Herterich V, Damblemont A, Hieber F, Böcker W, Polzer H. Open reduction and internal fixation of the posterior malleolus fragment frequently restores syndesmotic stability. Injury. 2019;50(2):564-70.
  21. Miller MA, McDonald TC, Graves ML, Spitler CA, Russell GV, Jones LC, et al. Stability of the Syndesmosis After Posterior Malleolar Fracture Fixation. Foot Ankle Int. 2018;39(1):99-104.
  22. Fitzpatrick E, Goetz JE, Sittapairoj T, Hosuru Siddappa V, Femino JE, Phisitkul P. Effect of Posterior Malleolus Fracture on Syndesmotic Reduction: A Cadaveric Study. J Bone Joint Surg Am. 2018;100(3):243-8.
  23. Jayatilaka MLT, Philpott MDG, Fisher A, Fisher L, Molloy A, Mason L. Anatomy of the Insertion of the Posterior Inferior Tibiofibular Ligament and the Posterior Malleolar Fracture. Foot Ankle Int. 2019;40(11):1319-24.
  24. Odak S, Ahluwalia R, Unnikrishnan P, Hennessy M, Platt S. Management of Posterior Malleolar Fractures: A Systematic Review. J Foot Ankle Surg. 2016;55(1):140-5.
  25. Blom RP, Hayat B, Al-Dirini RMA, Sierevelt I, Kerkhoffs G, Goslings JC, et al. Posterior malleolar ankle fractures. Bone Joint J. 2020;102-b(9):1229-41.
  26. Mason LW, Kaye A, Widnall J, Redfern J, Molloy A. Posterior Malleolar Ankle Fractures: An Effort at Improving Outcomes. JBJS Open Access. 2019;Latest Articles.
  27. Jeyaseelan L, Bua N, Parker L, Sohrabi C, Trockels A, Vris A, et al. Outcomes of posterior malleolar fixation in ankle fractures in a major trauma centre. Injury. 2020 [Epub ahead of print].

The anatomy of an awesome randomised trial

  1. Rangan A, Brealey SD, Keding A, et al. Management of adults with primary frozen shoulder in secondary care (UK FROST): a multicentre, pragmatic, three-arm, superiority randomised clinical trial. Lancet. 2020;396(10256):977-89.
  2. Dias JJ, Brealey SD, Fairhurst C, et al. Surgery versus cast immobilisation for adults with a bicortical fracture of the scaphoid waist (SWIFFT): a pragmatic, multicentre, open-label, randomised superiority trial. Lancet. 2020;396(10248):390-401.
  3. Costa ML, Achten J, Marian IR, et al. Plaster cast versus functional brace for non-surgical treatment of Achilles tendon rupture (UKSTAR): a multicentre randomised controlled trial and economic evaluation. Lancet. 2020;395(10222):441-48.
  4. Palmer AJR, Ayyar Gupta V, Fernquest S, et al. Arthroscopic hip surgery compared with physiotherapy and activity modification for the treatment of symptomatic femoroacetabular impingement: multicentre randomised controlled trial. BMJ. 2019;364:l185.
  5. Beard DJ, Davies LJ, Cook JA, et al. The clinical and cost-effectiveness of total versus partial knee replacement in patients with medial compartment osteoarthritis (TOPKAT): 5-year outcomes of a randomised controlled trial. Lancet. 2019;394(10200):746-56.
  6. Griffin DR, Dickenson EJ, Wall PDH, et al. Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHIoN): a multicentre randomised controlled trial. Lancet. 2018;391(10136):2225-35.
  7. Beard DJ, Rees JL, Cook JA, et al. Arthroscopic subacromial decompression for subacromial shoulder pain (CSAW): a multicentre, pragmatic, parallel group, placebo-controlled, three-group, randomised surgical trial. Lancet. 2018;391(10118):329-38.
  8. Raftery J, Young A, Stanton L, et al. Chapter 9, Theme 6: the cost of randomised trials, trends and determinants. Clinical trial metadata: defining and extracting metadata on the design, conduct, results and costs of 125 randomised clinical trials funded by the National Institute for Health Research Health Technology Assessment programme Southampton (UK): NIHR Journals Library; 2015 Feb. (Health Technology Assessment, No. 19.11.)
  9. NICE (2016). Fractures (non-complex): assessment and management. Available at: https://www.nice.org.uk/guidance/ng38. Last accessed 11th January 2021.
  10. Willett KM, Gray B, Moran CG, et al. Orthopaedic trauma research priority-setting exercise and development of a research network. Injury. 2010;41(7):763-7.
  11. Partridge N, Scadding J. The James Lind Alliance: patients and clinicians should jointly identify their priorities for clinical trials. Lancet. 2004;364(9449):1923-24.
  12. van Middendorp JJ, Allison H, Cowan K. Top ten research priorities for spinal cord injury. Lancet Neurol. 2014;13(12):1167.
  13. Rangan A, Upadhaya S, Regan S, et al. Research priorities for shoulder surgery: results of the 2015 James Lind Alliance patient and clinician priority setting partnership. BMJ Open. 2016;6(4):e010412.
  14. The James Lind Alliance (2021) [Available at: https://www.jla.nihr.ac.uk/. Last accessed 11th January 2021.
  15. Davies BM, Khan DZ, Mowforth OD, et al. RE-CODE DCM (REsearch Objectives and Common Data Elements for Degenerative Cervical Myelopathy): A Consensus Process to Improve Research Efficiency in DCM, Through Establishment of a Standardized Dataset for Clinical Research and the Definition of the Research Priorities. Global Spine J. 2019;9(1 suppl):65S-76S.
  16. Sheehan WJ, Williams MA, Paskins Z, et al. Research priorities for the management of broken bones of the upper limb in people over 50: a UK priority setting partnership with the James Lind Alliance. BMJ Open. 2019;9(12):e030028.
  17. Fernandez MA, Arnel L, Gould J, et al. Research priorities in fragility fractures of the lower limb and pelvis: a UK priority setting partnership with the James Lind Alliance. BMJ Open. 2018;8(10):e023301.
  18. Richardson WS, Wilson MC, Nishikawa J, et al. The well-built clinical question: a key to evidence-based decisions. ACP J Club. 1995;123(3):A12-3.
  19. O'Connor D, Green S, Higgins JPT. Defining the Review Question and Developing Criteria for Including Studies. In: Higgins JP, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions. Oxford: Cochrane Collaboration 2008:81-94.
  20. Paavola M, Malmivaara A, Taimela S, et al. Subacromial decompression versus diagnostic arthroscopy for shoulder impingement: randomised, placebo surgery controlled clinical trial. BMJ. 2018;362:k2860.
  21. Griffin D, Parsons N, Shaw E, et al. Operative versus non-operative treatment for closed, displaced, intra-articular fractures of the calcaneus: randomised controlled trial. BMJ. 2014;349:g4483.
  22. Costa ML, Achten J, Parsons NR, et al. Percutaneous fixation with Kirschner wires versus volar locking plate fixation in adults with dorsally displaced fracture of distal radius: randomised controlled trial. BMJ. 2014;349:g4807.
  23. Singal AG, Higgins PD, Waljee AK. A primer on effectiveness and efficacy trials. Clin Transl Gastroenterol. 2014;5(1):e45.
  24. Revicki DA, Frank L. Pharmacoeconomic evaluation in the real world. Effectiveness versus efficacy studies. Pharmacoeconomics. 1999;15(5):423-34.
  25. Marson BA, Craxford S, Deshmukh SR, et al. Outcomes reported in trials of childhood fractures: a systematic review. Bone Jt Open. 2020;1(5):167-74.
  26. Crosby BT, Behbahani A, Olujohungbe O, et al. Developing a core outcome set for paediatric wrist fractures: a systematic review of prior outcomes. Bone Jt Open. 2020;1(5):121-30.
  27. Srikandarajah N, Wilby M, Clark S, et al. Outcomes reported after surgery for cauda equina syndrome: a systematic literature review. Spine. 2018;43(17):E1005.
  28. Ollivere BJ, Marson BA, Haddad FS. Getting the right answer. Bone Joint J. 2019;101-B(3):233-35.
  29. Williamson PR, Altman DG, Bagley H, et al. The COMET handbook: version 1.0. Trials. 2017;18(3):280.
  30. Williamson PR, Altman DG, Blazeby JM, et al. The COMET (core outcome measures in effectiveness trials) initiative. Trials.2011;12(Suppl 1):A70.
  31. Kleinlugtenbelt Y, Nienhuis R, Bhandari M, et al. Are validated outcome measures used in distal radial fractures truly valid? A critical assessment using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Bone Joint Res. 2016;5(4):153-61.
  32. Marson BA, Craxford S, Deshmukh SR, et al. Quality of patient-reported outcomes used for quality of life, physical function, and functional capacity in trials of childhood fractures: a systematic review using the COSMIN checklist. Bone Joint J. 2020;102(12):1599-607.
  33. Gagnier JJ, Huang H, Mullins M, et al. Measurement properties of patient-reported outcome measures used in patients undergoing total hip arthroplasty: a systematic review. JBJS Rev. 2018;6(1):e2.
  34. Singh JA, Dohm M. Towards consensus on the reporting of core outcome domains in total joint replacement clinical trials: the derivation of the preliminary core outcome domain set. J Arthritis. 2016;5(6):1-5.
  35. Smith TO, Hawker GA, Hunter DJ, et al. The OMERACT-OARSI core domain set for measurement in clinical trials of hip and/or knee osteoarthritis. J Rheumatol. 2019;46(8):981-89.
  36. Haywood K, Griffin X, Achten J, et al. Developing a core outcome set for hip fracture trials. Bone Joint J. 2014;96(8):1016-23.
  37. Buchbinder R, Page MJ, Huang H, et al. A preliminary core domain set for clinical trials of shoulder disorders: a report from the OMERACT 2016 shoulder core outcome set special interest group. J Rheumatol. 2017;44(12):1880-83.
  38. Leo DG, Jones H, Murphy R, et al. The outcomes of Perthes’ disease: Development of a core outcomes set for clinical trials in Perthes’ disease. Bone Joint J. 2020;102(5):611-17.
  39. Clement RC, Welander A, Stowell C, et al. A proposed set of metrics for standardized outcome reporting in the management of low back pain. Acta Orthop. 2015;86(5):523-33.
  40. Marson BA, Manning JC, James M, et al. CORE-Kids: a protocol for the development of a core outcome set for childhood fractures. BMJ Open. 2020;10(2):e036224.
  41. Dorman SL, Shelton JA, Stevenson RA, et al. Management of medial humeral epicondyle fractures in children: a structured review protocol for a systematic review of the literature and identification of a core outcome set using a Delphi survey. Trials. 2018;19(1):1-7.
  42. Xue Z, Sun J, Li T, et al. How to evaluate the clinical outcome of joint-preserving treatment for osteonecrosis of the femoral head: development of a core outcome set. J Orthop Surg Res.2019;14(1):317.
  43. NIHR (2020). Research Design Service. Available at: https://www.nihr.ac.uk/explore-nihr/support/research-design-service.htm. [Last accessed 11th January 2021].
  44. British Orthopaedic Association (2020). BOA Orthopaedic Surgery Research Centre (BOSRC). Available at: https://www.boa.ac.uk/research/bosrcresearch.html. [Last accessed 11th January 2021].

Surgical rationing in times of COVID-19 pandemic – how does it affect the Montgomery ruling and GMC guidance on consent?

  1. Oxford English Dictionary. Available at: https://en.oxforddictionaries.com/definition/ration.
  2. Vise, R. (2015) Rationing care is a fact of life for the NHS. The Guardian, 24 April. Available at: www.theguardian.com/healthcare-network/2015/apr/24/rationing-care-fact-of-life-nhs.
  3. de Wilton A, Kilich E, Chaudhry Z, Ck Bell L, Gahir  J, Cadman J, et al. Delayed healthcare seeking and prolonged illness in healthcare workers during the COVID-19 pandemic: a single-centre observational study. BMJ Open. 2020;10(11):e040216.
  4. Odor PM , Neun M, Bampoe S, Clark S, Heaton D, Hoogenboom EM, et al. Anaesthesia and COVID-19: infection control. Br J Anaesth. 2020;125(1):16-24.
  5. Griffin S. Covid-19: Waiting times in England reach record highs. BMJ. 2020;370:m3557.
  6. Federation of Surgical Specialty Associations (2021). COVID-19 documents. Available at: https://fssa.org.uk/covid-19_documents.aspx.
  7. Truog RD, Brock DW, Cook DJ, Danis M, Luce JM, Rubenfeld GD, et al. Rationing in the intensive care unit. Crit Care Med. 2006 Apr;34(4):958-63; quiz 971.
  8. United Kingdom: Human Rights Act 1998  [United Kingdom of Great Britain and Northern Ireland], 9 November 1998, Available at: www.legislation.gov.uk/ukpga/1998/42/contents.
  9. Department for Health (2021). The NHS constitution for England. Available at: https://www.gov.uk/government/publications/the-nhs-constitution-for-england.
  10. Royal College Of Surgeons England (2017). New Report Shows Fall In Hip Replacements Due To Rationing. Available at: https://www.rcseng.ac.uk/news-and-events/media-centre/press-releases/kings-fund-hips-rationing/.
  11. British Orthopaedic Association (2021). Management of patients with urgent orthopaedic conditions and trauma during the coronavirus pandemic. Available at: https://www.boa.ac.uk/resources/covid-19-boasts-combined.html.
  12. Montgomery V Lanarkshire Health Board [2015] UKSC 11. Available at: https://www.supremecourt.uk/cases/uksc-2013-0136.html.
  13. BBC News (2021). Covid-19: Protect us from unlawful killing charges - medics. Available at: https://www.bbc.co.uk/news/uk-55689388.
  14. General Medical Council (2020). Decision making and consent. Available at: https://www.gmc-uk.org/-/media/documents/gmc-guidance-for-doctors---decision-making-and-consent-english_pdf-84191055.pdf?la=en&hash=BE327A1C584627D12BC51F66E790443F0E0651DA.
  15. General Medical Council (2018). Confidentiality: good practice in handling patient information. Available at: https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/confidentiality.

 

Arthroscopic menisectomy for isolated meniscal tears – changing practice

  1. Abram SGF, Beard DJ, Price AJ, BASK Meniscal Working Group. Arthroscopic meniscal surgery: a national society treatment guideline and consensus statement. Bone Joint J. 2019;101-B(6):652-659.
  2. Khan KM. Deimplementing arthroscopy, improving concussion reporting and celebrating research quality. Br J Sports Med. 2020;54:1305-1306.
  3. Abram SGF, Beard DJ, Hing CB, Price AJ. Evidence update: A summary of new evidence to inform treatment decisions for patients with meniscal lesions. Knee. 2019;26(3):521-523.
  4. Abram SGF, Beard DJ, Price AJ. National consensus on the definition, investigation, and classification of meniscal lesions of the knee. Knee. 2018;25(5):834-840.
  5. Sihvonen R, Paavola M, Malmivaara A, Itälä A, Joukainen A, Kalske J, et al. Arthroscopic partial meniscectomy for a degenerative meniscus tear: A 5 year follow-up of the placebo-surgery controlled FIDELITY (Finnish Degenerative Meniscus Lesion Study) trial. Br J Sports Med. 2020;54(22):1332-1339.
  6. Kise NJ, Risberg MA, Stensrud S, Ranstam J, Engebretsen L, Roos EM. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: Randomised controlled trial with two year follow-up. BMJ. 2016;354:i3740.
  7. Abram SGF, Hopewell S, Monk AP, Bayliss LE, Beard DJ, Price AJ. Arthroscopic partial meniscectomy for meniscal tears of the knee: A systematic review and meta-analysis. Br J Sports Med. 2020;54(11):652-663.
  8. Laprade RF, Spalding T, Murray IR, Chahla J, Safran MR, Larson CM, et al. Knee arthroscopy: Evidence for a targeted approach. Br J Sports Med. 2020. [Epub ahead of print].
  9. The Academy of Medical Royal Colleges (2020). Evidence based interventions Evidence-Based Interventions - List 2 Guidance. Available from: https://www.aomrc.org.uk/wp-content/uploads/2020/12/EBI_list2_guidance_050121.pdf.
 

 

Is ACL repair possible?

  1. Feagin JA, Curl WW. Isolated tear of the anterior cruciate ligament: 5-year follow-up study. Am J Sports Med. 1976;4(3):95-100.
  2. Sherman MF, Lieber L, Bonamo JR, Podesta L, Reiter I. The long-term follow up of primary anterior cruciate ligament repair. Defining a rationale for augmentation. Am J Sports Med. 1991;19(3):243-55.
  3. van der List JP, Mintz DN, DiFelice GS. The Location of Anterior Cruciate Ligament Tears: A Prevalence Study Using Magnetic Resonance Imaging. Orthop J Sports Med. 2017;5(6):2325967117709966.
  4. Ateschrang A, Schreiner AJ, Ahmad SS, Schröter S, Hirschmann MT, Körner D, et al. Improved results of ACL primary repair in one-part tears with intact synovial coverage. Knee Surg Sports Traumatol Arthrosc. 2019;27(1):37-43.
  5. Getgood AMJ, Bryant DM, Litchfield R, Heard M, McCormack RG, Rezansoff A, et al. Lateral Extra-articular Tenodesis Reduces Failure of Hamstring Tendon Autograft Anterior Cruciate Ligament Reconstruction: 2-Year Outcomes From the STABILITY Study Randomized Clinical Trial. Am J Sports Med. 2020;48(2):285-97.
  6. Difelice G, Villegas C, Taylor S. Anterior Cruciate Ligament Preservation: Early Results of a Novel Arthroscopic Technique for Suture Anchor Primary Anterior Cruciate Ligament Repair. Arthrosc J Arthrosc Relat Surg. 2015;31:2162-71.
  7. Mackay G, Anthony IC, Jenkins PJ, Blyth M. Anterior Cruciate Ligament Repair Revisited. Preliminary Results of Primary Repair with Internal Brace Ligament Augmentation: A Case Series. Orthop Muscular Syst. 2015;4(2):188.
  8. Murray MM, Fleming BC, Badger GJ, BEAR Trial Team, Freiberger C, Henderson R, et al. Bridge-Enhanced Anterior Cruciate Ligament Repair Is Not Inferior to Autograft Anterior Cruciate Ligament Reconstruction at 2 Years: Results of a Prospective Randomized Clinical Trial. Am J Sports Med. 2020;48(6):1305-15.
Return to Knowledge Hub