ObjectiveMagnetic resonance imaging (MRI) is paramount in the assessment of knee pathology, particularly when planning for a surgical procedure. This study compared the diagnostic accuracy in MRI reading of pathological knees by radiologists and orthopaedic surgeons.Materials and methodsCross-sectional study comprising 80 randomly selected patients previously submitted to arthroscopic surgery after clinical examination and MRI. A diagnosis by MRI interpretation was requested from the two teams, one of radiologists and another of orthopaedic surgeons. The conclusions of each team were later compared. Statistical significance was considered for p < 0.05.ResultsThe radiologists’ findings achieved statistical significance regarding osteochondral injuries, ACL, and medial meniscus (p < 0.05), and orthopaedic surgeons regarding ACL injuries and menisci (p < 0.05). ACL injuries demonstrated a statistically significant association between teams (p < 0.001).ConclusionsMRI appears to offer reliable readings of ACL injuries, regardless the specialty of the observer. The lateral compartment is scarcely well read.
Background: Prosthetic Joint Infection (PJI) is one of the most challenging problems in orthopaedic surgery and musculoskeletal infections specifically. Some very important controversies remain and strong evidence-based recommendations are still lacking in many clinical aspects. Therefore, an undisputed methodology of treatment does not exist yet and there are many different valid approaches.Purposes: To draw a picture of the different practice patterns around Europe and understand the motivations of the European Bone & Joint Infection Society (EBJIS) members in choosing between one- or two-stage revision surgery in treating chronic PJI.Methods: The participants of the 34th EBJIS Annual Meeting were surveyed through an online questionnaire. The survey assessed the main philosophy in the treatment of chronic PJI, personal and institutional information as well as the importance of different factors in choosing two-stage or one-stage procedures.Results: One hundred and forty-three participants responded to the survey, including a significant group of skilful orthopaedic surgeons with large experience in treating musculoskeletal infections. Primarily two-stage was the most common philosophy regrading treatment of chronic PJI (60.1%), followed by two-stage or one-stage accordingly (34,8%) and primarily one-stage (5,1%). Significant soft tissue compromise, failure of previous revision surgery attempts, highly resistant or unclear infective microorganism(s) preoperatively and patient presenting with sepsis or immunosuppression, were considered the more relevant factors in choosing two-stage instead one-stage procedures.Interpretation: Treatment of chronic PJI is challenging and demanding. An open dialogue to share the different experiences and a collective effort to plan a major multicentre research in order to establish standardized protocols are essential.
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