scholarly journals New classification of osteochondral lesions of the talus in adults

2021 ◽  
Vol 15 (1) ◽  
pp. 77-82
Author(s):  
Jorge Batista ◽  
German Joannas ◽  
Leandro Casola ◽  
Lucas Logioco ◽  
Guillermo Arrondo
Keyword(s):  
Mechanical Axis ◽  
Osteochondral Lesions ◽  
Associated Injuries ◽  
New Classification ◽  
Lateral Instability ◽  
Level Of Evidence ◽  
Chronic Instability ◽  
Hindfoot Deformities ◽  
Limb Deformities

Osteochondral lesions (OCL) of the ankle in adults are frequent lesions that mainly affect the cartilage and the subchondral bone, are relatively common, and have varied etiologies. However, in 50% of patients, these lesions may occur concomitantly with chronic instability of the ankle associated with lower limb deformities, acute sprains of the ankle, or fractures. We propose a classification into four types of lesions (traumatic, non-traumatic, with lateral instability of the ankle, and with mechanical axis defects), focusing not only on the diagnosis and treatment of OCL but also on associated injuries, such as instability and/or supramalleolar and hindfoot deformities. Level of Evidence V; Therapeutic Studies; Expert Opinion.

scholarly journals Independent Reliability Analysis of a New Classification for Pyogenic Spondylodiscitis

2020 ◽  
pp. 219256822091909
Author(s):  
Gaston Camino Willhuber ◽  
Alfredo Guiroy ◽  
Juan Zamorano ◽  
Nelson Astur ◽  
Marcelo Valacco
Keyword(s):  
Reliability Analysis ◽  
Interobserver Agreement ◽  
Random Sequence ◽  
Diagnostic Study ◽  
Intraobserver Agreement ◽  
Resonance Imaging ◽  
New Classification ◽  
Level Of Evidence ◽  
Pyogenic Spondylodiscitis

Study Design: Diagnostic study, level of evidence III. Objective: Pyogenic spondylodiscitis can cause deformity, neurological compromise, disability, and death. Recently, a new classification of spondylodiscitis based on magnetic resonance imaging was published. The objective of this study is to perform an independent reliability analysis of this new classification. Methods: We selected 35 cases from our database of different spine centers in Latin America and from the literature; 8 observers evaluated the classification and graded the scenarios according to the methodological grading of the classification developed by Pola et al. Cases were sent to the observers in a random sequence after 3 weeks to assess intraobserver reliability. The interobserver and intraobserver reliabilities were performed with Fleiss and Cohen statistics, respectively. Results: The overall Fleiss κ value for interobserver agreement was substantial, with 0.67 (95% CI = 0.43-0.91) in the first reading and 0.67 (95% CI = 0.45-0.89) in second reading for the main types of classification. The Cohen κ value for intraobserver agreement was also substantial, with 0.68 (95% CI = 0.45-0.92). The interobserver agreement analysis for the subtypes of this classification was overall substantial, with 0.60 (95% CI = 0.37-0.83) in the first reading and 0.61 (95% CI = 0.41-0.81) in the second reading. The overall intraobserver agreement for subtypes of the classification was also substantial, with 0.63 (95% CI = 0.34-0.93). Conclusion: The new classification developed by Pola et al showed substantial interobserver and intraobserver agreements. More studies are required to validate the usefulness of this classification especially in clinical practice.

New Classification of Gemstone Colours

1971 ◽  
Vol 12 (7) ◽  
pp. 262-266
Author(s):  
K. F. Chudoba
Keyword(s):  
New Classification

Reductionism and holism in the philosophy of medicine

2020 ◽  
pp. 66-74
Author(s):  
E. Zakablukovskiy
Keyword(s):  
Philosophy Of Medicine ◽  
Point Of View ◽  
Social Model ◽  
Macro Level ◽  
New Classification

The article highlights certain aspects of the discussion on the topic of reductionism vs. holism in the philosophy of medicine. Classic radical reductionism is defeated by the concept of emergence. The s.c. bio-medical point of view on a malady, despite its relevance and clear benefit, is not recognized as universal as its adherents may claim, and it yields to an integral psycho-bio-social model. The author introduces a new classification of holism (vitalistic, social and individualistic) and makes appropriate recommendations to clinicians. It is social holism at the macro level that has proven effective in combating the spread of COVID-19.

scholarly journals A New Classification of Ficus

1977 ◽  
Vol 64 (2) ◽  
pp. 296 ◽  
Author(s):  
William Ramirez B.
Keyword(s):  
New Classification

Proposal for a new classification of vibratory urticaria/angioedema

2021 ◽  
Vol 9 (6) ◽  
pp. 2542-2543 ◽  
Author(s):  
María Antonia Pastor-Nieto ◽  
María Elena Gatica-Ortega ◽  
Laura Vergara-de-la-Campa ◽  
Ana María Giménez-Arnau
Keyword(s):  
New Classification

Long-term Outcomes of Microfracture for Treatment of Osteochondral Lesions of the Talus

2021 ◽  
pp. 107110072199542
Author(s):  
Daniel Corr ◽  
Jared Raikin ◽  
Joseph O’Neil ◽  
Steven Raikin
Keyword(s):  
Survival Rate ◽  
Case Series ◽  
Return To Sport ◽  
Osteochondral Lesions ◽  
Long Term Outcomes ◽  
Level Of Evidence ◽  
Additional Surgery ◽  
Case Series Study

Background: Microfracture is the most common reparative surgery for osteochondral lesions of the talus (OLTs). While shown to be effective in short- to midterm outcomes, the fibrocartilage that microfracture produces is both biomechanically and biologically inferior to that of native hyaline cartilage and is susceptible to possible deterioration over time following repair. With orthobiologics being proposed to augment repair, there exists a clear gap in the study of long-term clinical outcomes of microfracture to determine if this added expense is necessary. Methods: A retrospective review of patients undergoing microfracture of an OLT with a single fellowship-trained orthopedic surgeon from 2007 to 2009 was performed. Patients meeting the inclusion criteria were contacted to complete the Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and Sports subscales and visual analog scale (VAS) for pain, as well as surveyed regarding their satisfaction with the outcome of the procedure and their likelihood to recommend the procedure to a friend with the same problem using 5-point Likert scales. Patient demographics were reviewed and included for statistical analysis. Results: Of 45 respondents, 3 patients required additional surgery on their ankle for the osteochondral defect, yielding a 10-year survival rate of 93.3%. Of surviving cases, 90.4% (38/42) reported being “extremely satisfied” or “satisfied” with the outcome of the procedure. The VAS score at follow-up averaged 14 out of 100 (range, 0-75), while the FAAM-ADL and FAAM-Sports scores averaged 90.29 out of 100 and 82 out of 100, respectively. Thirty-six patients (85.7%) stated that their ankle did not prevent them from participating in the sports of their choice. Conclusion: The current study represents a minimum 10-year follow-up of patients undergoing isolated arthroscopic microfracture for talar osteochondral defects, with a 93.3% survival rate and 85.7% return to sport. While biological adjuvants may play a role in improving the long-term outcomes of microfracture procedures, larger and longer-term follow-up studies are required for procedures using orthobiologics before their cost can be justified for routine use. Level of Evidence: Level IV, retrospective cohort case series study.

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