Biomedical subjects

C Niek van Dijk

Publications and source records attributed to C Niek van Dijk.

At least 19 recordsLinked to original sources

PubMed2006

Translation and validation of the Dutch version of the International Knee Documentation Committee Subjective Knee Form.

BACKGROUND: For knee-related surgery, there is a great demand for internationally useable subjective scoring systems. Before such measurements can be used, they should be translated and validated for the population they are used on. For the Dutch population, only the Western Ontario and McMaster Universities Osteoarthritis Index and Oxford 12 Questionnaire have been validated. However, these scores can only be used regarding osteoarthritis of the knee. In 2001, the International Knee Documentation Committee presented the Subjective Knee Form, which is a knee-specific rather than a disease-specific questionnaire. STUDY DESIGN: Cohort study (diagnosis/symptom prevalence); Level of evidence, 2. METHODS: The authors describe the translation procedure and validation of the Dutch Subjective Knee Form. After a forward-backward translation protocol, the reliability, validity, and content validity were tested. The responses of 145 consecutive knee patients on 2 questionnaires containing the Short Form-36, Western Ontario and McMaster Universities Osteoarthritis Index, Oxford 12 Questionnaire score, a visual analog scale, and the Dutch International Knee Documentation Committee Subjective Knee Form were used. Reliability was tested by measuring the test-retest reliability and internal consistency. Validity was tested by correlating the questionnaire to the other outcome measurements, and content validity was tested by measuring the floor and ceiling effects. RESULTS: The reliability proved excellent with an intraclass coefficient of 0.96 for test-retest. Internal consistency was strong (Cronbach alpha, .92). The construct, convergent, and divergent validities were good. The content validity was good; no floor or ceiling effect occurred. CONCLUSION: The validation procedure shows that the Dutch International Knee Documentation Committee Subjective Knee Form is an excellent evaluation instrument for Dutch patients with knee-related injuries.

Adult↗

PubMed2006

Achilles tendoscopy.

Noninsertional Achilles tendon-related problems can be treated well by an endoscopic approach if they do not respond to nonoperative management. Understanding the anatomy and the mechanical aspects of the hindfoot and having experience with endoscopic procedures are necessary. A retrospective study of 20 patients showed good results.

Achilles Tendon↗

PubMed2006

Anterior ankle impingement.

The anterior ankle impingement syndrome is a clinical pain syndrome that is characterized by anterior ankle pain on (hyper) dorsiflexion. The plain radiographs often are negative in patients who have anteromedial impingement. An oblique view is recommended in these patients. Arthroscopic excision of soft tissue overgrowths and osteophytes is an effective way of treating anterior impingement of the ankle in patients who have no narrowing of the joint space. For grade II lesions (osteophytes secondary to arthritis with joint space narrowing) arthroscopic treatment is a good option, because no other therapeutic option is available with the exception of an arthrodesis or prothesis.

Ankle Injuries↗

PubMed2006

Ankle instability.

The ankle joint is the most congruent joint of the human body. Stability is provided by the bony configuration of the ankle mortise and the talar dome and by the ankle ligaments. During ankle motions, rotation and translation around and along the movement axes occur. Soft tissue stability is provided mainly by the ligaments. This article discusses ankle instability, injuries, and reconstruction.

Ankle Injuries↗

PubMed2006

Endoscopic calcaneoplasty.

This article describes the technique of endoscopic calcaneoplasty and the results of a consecutive group of patients that was treated in the prone position in the authors' hospital.

Bursitis↗

PubMed2006

Tendoscopy of the posterior tibial tendon.

Posteromedial ankle complaints are most often caused by a disorder of the posterior tibial tendon. Two predominant groups of patients can be distinguished: the first involves younger patients who have some form of systemic inflammatory disease; the second involves older patients whose dysfunction is caused by chronic overuse. This article illustrates endoscopy of the posterior tibial tendon in a group of patients who had diverse pathology. None of the patients showed postoperative complications. All showed a quick recovery, early mobilization, none or mild postoperative pain, and nice wound healing. Although not all patients were free of complaints, all were satisfied with the intervention itself. Tendoscopy of the poterior tibial tendon offers the advantage of less morbidity, reduction of the postoperative pain, early mobilization, no wound healing problems and outpatient treatment.

Ankle↗

PubMed2006

Hindfoot endoscopy.

Hindfoot pain can be caused by a variety of pathologies; most of these can be diagnosed and treated by means of endoscopy. The main indications are posterior tibial tenosynovectomy, diagnosis of a peroneus brevis length rupture, peroneal tendon athesiolysis, flexor hallucis longus release, os trigonum removal, endoscopic treatment for retrocalcaneal bursitis, endoscopic treatment for Achilles (peri)tendinopathy, and treatment of ankle joint or subtalar joint pathology. The advantages of endoscopic hindfoot surgery over open surgery are less morbidity, reduction of postoperative pain, outpatient treatment, and functional postoperative treatment. This two-portal hindfoot endoscopy approach is a safe, reliable, and exciting method to diagnose and treat a variety of posterior ankle problems and offers a good alternative to open surgery.

Ankle Joint↗

PubMed2006

Tendoscopy of the peroneal tendons.

Tendoscopy of the peroneal tendons is a useful tool to diagnose and treat peroneal tendon disorders. Endoscopic ankle surgery is followed by a functional postoperative treatment and offers the advantages of less morbidity, reduction of postoperative pain, and outpatient surgery. The article describes the technique and results of peroneal tendoscopy performed in 23 patients between 1995 and 2000.

Endoscopy↗

PubMed2006

Arthroscopy of the posterior subtalar joint.

The subtalar joint is a complex and functionally important joint of the lower extremity. It plays a major role in the movement of inversion and eversion of the foot. With the development of small-joint arthroscopes and instrumentation, surgeons became interested in posterior subtalar joint arthroscopy. Diagnostic and therapeutic indications for this technique have increased; however, arthroscopic subtalar surgery is technically difficult and should be performed by an experienced arthroscopist. The number of reports dealing with posterior subtalar arthroscopy remains relatively small.

Arthroscopy↗

PubMed2006

Current concepts: treatment of osteochondral ankle defects.

Osteochondral ankle defects cause various symptoms including pain, swelling, and limited range of motion. When surgical treatment is necessary, several treatment options exist. Arthroscopic debridement and drilling, arthroscopic autologous osteochondral transplantation (mosaiclasty), and autologous chondrocyte transplantation are discussed more extensively. Treatment results of each technique are discussed, and a guideline for treatment is presented.

Ankle Joint↗

PubMed2006

Anterior and posterior ankle impingement.

Anterior ankle impingement is characterized by anterior ankle pain on activity. Recurrent (hyper) dorsiflexion is often the cause. Typically, there is pain on palpation at the anteromedial or anterolateral joint line. Some swelling or limitation in dorsiflexion are present. Plain radiographs can disclose the cause of the impingement. In the case of spurs or osteophytes, the diagnosis is anterior bony impingement. In the absence of spurs or osteophytes, the diagnosis is anterior soft tissue impingement. In patients with anteromedial impingement, plain radiographs ae often falsely negative. An oblique view (anteromedial impingement view = AMI view) is recommended in these patients. Arthroscopic management with removal of the offending tissue provides good to excellent long-term (5-8 years) results in 83% of patients with grade 0 and grade I lesions. Long-term results are good/excellent in 50% of patients with grade II lesions (osteophytes secondary to arthritis with joint space narrowing). In posterior ankle impingement, patients experience hindfoot pain when the ankle is forcedly plantarflexed. Trauma or overuse can be the cause. The trauma mechanism is hyperplantarflexion or a combined inversion plantarflexion injury. Overuse injuries typically occur in ballet dancers and downhill runners, who report pain on palpation at the posterolateral aspect of the talus. On plain radiographs, an os trigonum or hypertrophic posterior or talar process can be detected. Surgical management involves removal of the os trigonum, scar tissue, or hypertrophic posterior talar process. In the case of combined posterior bony impingement and flexor hallucis longus tendinopathy, a release of the flexor hallucis longus is performed simultaneously. Endoscopic management is associated with a low morbidity, a short recovery time, and provides good/excellent results at 2-5 years follow-up in 80% of patients.

Ankle Joint↗

PubMed2006

Two and three-dimensional computed tomography for the classification and management of distal humeral fractures. Evaluation of reliability and diagnostic accuracy.

BACKGROUND: Complex fractures of the distal part of the humerus can be difficult to characterize on plain radiographs and two-dimensional computed tomography scans. We tested the hypothesis that three-dimensional reconstructions of computed tomography scans improve the reliability and accuracy of fracture characterization, classification, and treatment decisions. METHODS: Five independent observers evaluated thirty consecutive intra-articular fractures of the distal part of the humerus for the presence of five fracture characteristics: a fracture line in the coronal plane; articular comminution; metaphyseal comminution; the presence of separate, entirely articular fragments; and impaction of the articular surface. Fractures were also classified according to the AO/ASIF Comprehensive Classification of Fractures and the classification system of Mehne and Matta. Two rounds of evaluation were performed and then compared. Initially, a combination of plain radiographs and two-dimensional computed tomography scans (2D) were evaluated, and then, two weeks later, a combination of radiographs, two-dimensional computed tomography scans, and three-dimensional reconstructions of computed tomography scans (3D) were assessed. RESULTS: Three-dimensional computed tomography improved both the intraobserver and the interobserver reliability of the AO classification system and the Mehne and Matta classification system. Three-dimensional computed tomography reconstructions also improved the intraobserver agreement for all fracture characteristics, from moderate (average kappa [kappa2D] = 0.554) to substantial agreement (kappa3D = 0.793). The addition of three-dimensional images had limited influence on the interobserver reliability and diagnostic characteristics (sensitivity, specificity, and accuracy) for the recognition of specific fracture characteristics. Three-dimensional computed tomography images improved intraobserver agreement (kappa2D = 0.62 compared with kappa3D = 0.75) but not interobserver agreement (kappa2D = 0.24 compared with kappa3D = 0.28) for treatment decisions. CONCLUSIONS: Three-dimensional reconstructions improve the reliability, but not the accuracy, of fracture classification and characterization. The influence of three-dimensional computed tomography was much more notable for intraobserver comparisons than for interobserver comparisons, suggesting that different observers see different things in the scans-most likely a reflection of the training, knowledge, and experience of the observer with regard to these relatively uncommon and complex injuries.

Adult↗

PubMed2006

Hindfoot endoscopy for posterior ankle pain.

Hindfoot pain can be caused by a variety of pathologies, most of which can be diagnosed and treated with endoscopy. The main indications are posterior tibial tenosynovectomy, diagnosis of a longitudinal peroneus brevis rupture, peroneal tendon adhesiolysis, flexor hallucis longus release, os trigonum removal, endoscopic treatment of retrocalcaneal bursitis, endoscopic treatment of Achilles (peri)tendinopathy, and treatment of ankle joint or subtalar joint pathology. The advantages of endoscopic hindfoot surgery over open surgery are less morbidity, reduction of postoperative pain, outpatient treatment, and functional postoperative treatment. Optimal portal placement for each indication has been identified in a cadaver study. The approach for the flexor hallucis longus and os trigonum is particularly challenging because of the adjacent neurovascular bundle. A two-portal hindfoot approach with the patient in the prone position offers excellent access to the flexor hallucis longus. The posterior ankle compartment, os trigonum, and subtalar joint can be visualized and treated through this approach. In 240 consecutive procedures, no major complications were reported. The two-portal hindfoot endoscopy approach is a safe, reliable, and exciting method to diagnose and treat a variety of posterior ankle problems. Endoscopic calcaneoplasty for retrocalcaneal bursitis offers a good alternative to open resection. Experienced arthroscopic surgeons will find this technique rewarding.

Ankle Joint↗

PubMed2005

The predictive value of the extensor grip test for the effectiveness of bracing for tennis elbow.

BACKGROUND: Tennis elbow is a common complaint. Several treatment strategies, such as corticosteroid injections and physical therapy and braces, have been described. HYPOTHESIS: The extensor grip test has predictive value in assessing the effectiveness of bracing in tennis elbow. STUDY DESIGN: Cohort study (prognosis); Level of evidence, 1. METHODS: Patients with tennis elbow complaints were randomized into 3 groups: brace only, physical therapy, and combination brace and physical therapy. The extensor grip test was performed before randomization on all patients. Outcome measures at 6-week follow-up were success rate, severity of complaints, pain, disability, inconvenience during daily life, and satisfaction. RESULTS: In the brace-only group, significant differences were identified between patients with a positive test result and patients with a negative test result for 3 outcome measures. The success rate in the test-negative group was 23% (5/22) compared to 47% (21/45) in the test-positive group. Mean decrease in pain was 23 (95% confidence interval, -3 to 49) in the test-positive group compared to 11 (95% confidence interval, -6 to 28) in the test-negative group, and mean satisfaction in the test-positive group was 71 (95% confidence interval, 48 to 94) compared to 51 (95% confidence interval, 24 to 78) in the test-negative group. In the physical therapy and combination groups, no differences were identified between test-positive and test-negative patients. CONCLUSION: The extensor grip test seems valuable as a predictive factor for the effectiveness of bracing as treatment for tennis elbow over the short term.

Adult↗

PubMed2005

Two ankle joint laxity testers: reliability and validity.

Two test devices were manufactured to objectively measure ankle joint laxity: the dynamic anterior ankle tester (DAAT) and the quasi-static anterior ankle tester (QAAT). The primary aim was to analyse the reliability of both testers; The secondary aim was to assess validity in correlation with TELOS stress test and manual anterior drawer test. Twenty-four normal subjects and 14 patients 1 year after acute lateral ankle ligament injury were included. Both ankles were tested with the DAAT and QAAT by two different observers; one experienced orthopaedic surgeon performed the manual test; the TELOS stress X-rays were evaluated by one observer. Intra observer reliability for the DAAT varied between 0.81 and 0.94; for the QAAT between 0.71 and 0.94. Inter observer reliability for the DAAT varied between 0.84 and 0.94; for the QAAT between 0.76 and 0.82. Concurrent validity showed fair correlation between DAAT and QAAT for the first couple observers (0.71); however, a poor correlation was observed for the second couple (0.42). No significant correlations were found between neither DAAT and the TELOS and the manual test, nor QAAT and the TELOS and the manual test. In conclusion, reliability of both testers is high. Validity of the testers needs further investigation.

Adult↗

PubMed2005

Prospective study on diagnostic strategies in osteochondral lesions of the talus. Is MRI superior to helical CT?

Our aim in this prospective study was to determine the best diagnostic method for discriminating between patients with and without osteochondral lesions of the talus, with special relevance to the value of MRI compared with the new technique of multidetector helical CT. We compared the diagnostic value of history, physical examination and standard radiography, a 4 cm heel-rise view, helical CT, MRI, and diagnostic arthroscopy for simultaneous detection or exclusion of osteochondral lesions of the talus. A consecutive series of 103 patients (104 ankles) with chronic ankle pain was included in this study. Of these, 29 with 35 osteochondral lesions were identified. Twenty-seven lesions were located in the talus. Our findings showed that helical CT, MRI and diagnostic arthroscopy were significantly better than history, physical examination and standard radiography for detecting or excluding an osteochondral lesion. Also, MRI and diagnostic arthroscopy performed better than a mortise view with a 4 cm heel-rise. We did not find a statistically significant difference between helical CT and MRI. Diagnostic arthroscopy did not perform better than helical CT and MRI for detecting or excluding an osteochondral lesion.

Adolescent↗

PubMed2004

Measuring alignment of the hindfoot.

In subtalar arthrodesis operations, correction of the hindfoot alignment is performed in about half of the cases. To improve the quality of the operation, a measurement system was developed which reliably measures the hindfoot angle pre-, per-, and postoperatively. This device was evaluated by measuring subjects in standing weightbearing position and in prone nonweightbearing position. The results were compared with hindfoot angles constructed on posterior photographic images. The results are similar to other studies (all maximum values): intratester accuracy 1.4 degrees, intertester accuracy 2.2 degrees, intratester reliability 0.9, and intertester reliability 0.74. The proposed device will improve the quality of correction, because it enables peroperative measurement of hindfoot alignment.

Equipment Design↗

PubMed2004

The anterior ankle impingement syndrome: diagnostic value of oblique radiographs.

BACKGROUND: The diagnostic value of an oblique radiograph, in addition to a lateral radiograph, for detecting osteophytes in the anterior ankle impingement syndrome was evaluated in a prospective study. The hypothesis was that the application of a lateral radiograph is insufficient to detect osteophytes that are located in the anteromedial aspect of the ankle joint. Oblique anteromedial impingement (AMI) radiographs were hypothesized to be a relevant adjunct, because of their utility to detect these anteromedially located osteophytes. METHODS: Presence or absence of tibial and talar osteophytes on both radiographs was compared with the combined findings of CT, MRI scan, and arthroscopic surgery. Estimates of test characteristics were obtained for 60 consecutive patients with an anterior ankle impingement syndrome. RESULTS: It was shown that the sensitivity of lateral radiographs for detecting anterior tibial and talar osteophytes was 40% and 32%, respectively (specificity, 70% and 82%). When the lateral radiograph was combined with an oblique AMI radiograph, these figures increased to 85% and 73%, respectively (specificity decreased to 45% and 68%). This increase was due to the high sensitivity of the oblique AMI radiographs for detecting anteromedial osteophytes (93% for tibial and 67% for talar osteophytes). CONCLUSION: A lateral radiograph is insufficient to detect all anteriorly located osteophytes. An oblique AMI radiograph is a useful adjunct to routine radiographs and is recommended to detect anteromedial tibial and talar osteophytes.

Adolescent↗