The Copenhagen Standardised MRI protocol demonstrated moderate-to-substantial reliability in rating bone marrow oedema, and varied from fair-to-substantial agreement for the majority of MRI features, but showed only slight agreement in rating adductor longus tendinopathy. This rigorous investigation also confirms that while MRI evaluation seems to provide reasonable reliability in rating pubic bone marrow oedema, the evaluation of adductor tendinopathy in a clinical and research setting needs further resolution by continued development and testing of MRI acquisition protocols.
Background and purpose —Slipped capital femoral epiphysis is thought to result in cam deformity and femoroacetabular impingement. We examined: (1) cam-type deformity, (2) labral degeneration, chondrolabral damage, and osteoarthritic development, and (3) the clinical and patient-reported outcome after fixation of slipped capital femoral epiphysis (SCFE).Methods —We identified 28 patients who were treated with fixation of SCFE from 1991 to 1998. 17 patients with 24 affected hips were willing to participate and were evaluated 10–17 years postoperatively. Median age at surgery was 12 (10–14) years. Clinical examination, WOMAC, SF-36 measuring physical and mental function, a structured interview, radiography, and MRI examination were conducted at follow-up.Results —Median preoperative Southwick angle was 22o (IQR: 12–27). Follow-up radiographs showed cam deformity in 14 of the 24 affected hips and a Tönnis grade > 1 in 1 affected hip. MRI showed pathological alpha angles in 15 affected hips, labral degeneration in 13, and chondrolabral damage in 4. Median SF-36 physical score was 54 (IQR: 49–56) and median mental score was 56 (IQR: 54–58). These scores were comparable to those of a Danish population-based cohort of similar age and sex distribution.Median WOMAC score was 100 (IQR: 84–100).Interpretation —In 17 patients (24 affected hips), we found signs of cam deformity in 18 hips and early stages of joint degeneration in 10 hips. Our observations support the emerging consensus that SCFE is a precursor of cam deformity, FAI, and joint degeneration. Neither clinical examination nor SF-36 or WOMAC scores indicated physical compromise.
Elite swimmers and controls had similar prevalence of DD and LBP, although the pattern of DD differed between the groups. In case of DD, swimmers reported less LBP, although N.S.
Purpose Retraction of semitendinosus muscle has been reported after reconstruction of the anterior cruciate ligament with semitendinosus/gracilis-graft. However, very little data exist on the natural variation in side-to-side length symmetry. The purpose of this study was to investigate the side-to-side asymmetry of semitendinosus muscle length in individuals with ACL reconstruction (ACLR) using the semitendinosus/gracilis-graft compared to a group of healthy control subjects to establish the level of retraction that can conidently be ascribed the surgery. Methods Eleven subjects aged 30 (19-39) years, with previous unilateral ACLR with the combined semitendinosus/gracilis tendon graft were recruited. Average follow-up was 6.8 years (0.3-13.0) after reconstruction. Ten healthy subjects aged 30 years (23-36) with no previous knee surgery served as controls. Bilateral magnetic resonance imaging (MRI) scans were obtained of the thigh from 60 mm below the knee joint and 700 mm proximal to this point with a slice thickness of 5 mm with 5 mm inter-slice distance. Semitendinosus length was measured on both legs between the distal and proximal musculotendinous junction of the semitendinosus. Length diference between legs was calculated for all participants. Percentage of shortening was expressed relative to the healthy leg. Results Subjects who had undergone ACLR had on average 81 mm (25%) shortening of the semitendinosus on the reconstructed leg compared to the non-reconstructed side. The healthy subjects all had less than 10 mm diference between legs (< 3%). The side-to-side diference was signiicantly diferent between the reconstructed patients and the healthy subjects (p < 0.001). Conclusion This study indicates that retraction larger than 10 mm is a consequence of the tendon harvest and not natural variation. It also supports that persistent retraction of the semitendinosus muscle occurs following harvest of the semitendinosus tendon for ACL graft. Level of evidence Level IV.
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