Papers by Arthur Van Noort
Clinics in Sports Medicine, 2001
JSES international, Apr 1, 2024
Archives of Orthopaedic and Trauma Surgery, Dec 5, 2003
We present the case of a patient who was treated by open reduction and internal fixation for a di... more We present the case of a patient who was treated by open reduction and internal fixation for a displaced glenoid fracture using a limited posterior approach.
The journal of bone and joint surgery, Aug 1, 2001
T he aim of this retrospective study was to review a series of patients with ipsilateral fracture... more T he aim of this retrospective study was to review a series of patients with ipsilateral fractures of the neck of the scapula and of the clavicle. Between 1991 and 1996 a total of 79 general and orthopaedic surgeons treated 46 patients with a floating shoulder in The Netherlands. The records and radiographs of these patients were studied. Of the 35 patients available for follow-up, 31 had initially been treated conservatively and four by operation; three underwent secondary reconstructive surgery. The mean Constant score for the 28 patients treated conservatively was 76 and for the seven treated operatively it was 71 at a mean follow-up of 35 months. In six of the 28 patients treated conservatively the glenoid was dislocated caudally at the end of treatment; they had a score of 42. In the 22 patients without this dislocation the score was 85. We conclude that this rare injury is not inherently unstable and, in the absence of caudal dislocation of the glenoid, conservative treatment gives a good functional outcome.
Shoulder & Elbow, Jul 28, 2023
Background This multicentre retrospective cohort study assessed whether functional outcomes after... more Background This multicentre retrospective cohort study assessed whether functional outcomes after primary reverse shoulder arthroplasty (RSA) are favourable compared to secondary placement in elderly patients with displaced proximal humerus fractures (PHFs). Methods Fifty-three patients with primary and 32 with secondary RSA were included. Patient-reported outcome measures (PROMs) were assessed: Constant–Murley Score (CMS), Oxford Shoulder Score (OSS), Disabilities of the Arm, Shoulder and Hand (DASH) score, and Visual Analogue Scale (VAS). In addition, range of motion (ROM) was compared between groups. Result For PROMs, the means (SD) for primary versus secondary were 25.4 (17.7), 29.4 (19.2) for DASH; 38 (8.6), 38 (9.1) for OSS; 63 (19.8), 59 (22.0) for CMS and 2 (2.0), 3 (2.3) for VAS. For ROM, the means were the following: forward flexion 113° (33.6), 106° (34.1); abduction 103° (33.4), 96° (37.3) and external rotation 20° (19.1), 20° (17.8). There were significant differences in favour of primary treatment in forward flexion (p = 0.003, B 19.85) and abduction (p = 0.034, B 17.34). Discussion ROM in patients with complex displaced PHFs after primary RSA is slightly better than that after secondary treatment. Therefore, RSA could be considered primary treatment, especially when optimal ROM is of great importance to the patient. Level of evidence level III, retrospective comparative study treatment study
Clinics in Shoulder and Elbow, Jun 1, 2023
Background: Acromioclavicular (AC) osteoarthritis (OA) is a frequent pathology of the shoulder in... more Background: Acromioclavicular (AC) osteoarthritis (OA) is a frequent pathology of the shoulder in elderly patients. Drug injection plays an important role in treatment of AC OA. Literature has demonstrated excellent short-term results regarding shoulder function and pain. However, mid-to long-term results are lacking. The aim of this study was to assess the efficacy of a single intra-articular AC injection in patients with AC OA and to identify predictive factors for success. Methods: A retrospective study was performed to analyze success rate, shoulder function, and pain perception after a single intra-articular injection in patients with AC OA. Success was defined as the absence of reinterventions such as additional injection or surgery. Outcome measures were 1-year success rate and clinical outcome scores of Numeric Rating Scale (NRS) for pain, Oxford Shoulder Score, and Subjective Shoulder Value. Results: Ninety-eight patients participated in this study. At a median final follow-up of 0.8 years (interquartile range, 0-6), 57 of these patients (58%) had undergone a reintervention. The 1-year success rate was 47% (95% confidence interval, 37%-57%), with NRS at rest as the sole factor significantly associated with success. Thirty patients not requiring reintervention reported significant improvement from baseline for all reported outcome measures at final follow-up. Conclusions: AC injections offer a 1-year success rate of 47%. The AC injection produces good mid-to long-term clinical outcomes regarding shoulder function, quality of life, and pain perception in one-third of patients. Further research is essential to analyze mid-to longterm outcomes of AC injections. Level of evidence: Level IV.
Nederlands Tijdschrift voor Geneeskunde, 2010
A 53-year-old man presented with a shortend exorotated left leg and a flexed painfull left hip af... more A 53-year-old man presented with a shortend exorotated left leg and a flexed painfull left hip after a soccer accident. X-ray of the hip revealed an anterior hip dislocation, for which the patient was succesfully treated by reduction of the hip replacement in the operating room
Knee, Mar 1, 2021
Early recognition of potential predictors on the success of conservative treatment of anterior cr... more Early recognition of potential predictors on the success of conservative treatment of anterior cruciate ligament (ACL) is important, as appropriate treatment can be applied to each individual patient. The goal of this study is to assess the patient demographic and radiological parameters that predict coping with ACL injuries. All patients presenting with a complete ACL injury between 2014 and 2018 at our clinic were included. The role of patient demographics (age, gender, activity level, meniscus injury and time from injury to clinic), and ACL tear location, bone bruises, tibial slope, and anterolateral ligament (ALL) injury were assessed on the success of conservative treatment using univariate and multivariate analyses. Sixty-five patients (32%) were copers and 141 (68%) were non-copers. Univariate analysis showed that copers were significantly older (40 vs. 27 years, P < 0.001), had lower preinjury activity level (Tegner 5.7 vs. 6.5, P < 0.001) and less often lateral meniscus tears (16% vs. 5%, P = 0.019) but not medial meniscus tears (17% vs. 14%, P = 0.609) than non-copers. Multivariate analysis revealed that increasing age (P < 0.001), Tegner level ≤ 6 (P = 0.003) and no meniscus injury (P = 0.045) were independent predictors of coping with ACL deficiency. Older age, participation in lower activity sports levels and absence of meniscus injury were predictive of coping with ACL deficiency, whereas there was no such role for tear location, tibial slope, lateral bone bruise presence, ALL injury or gender. These findings might help to identify potential copers and guide surgeons early in the optimal treatment for patients with ACL injury.
PubMed, 2013
A 72-year-old male presented with a dorsomedial swelling of the knee. X-rays showed isolated ossi... more A 72-year-old male presented with a dorsomedial swelling of the knee. X-rays showed isolated ossificated cartilage particles. The particles, which were found to be in a popliteal cyst, were surgically removed and analyzed by the pathologist. The diagnosis was synovial osteochondromatosis . Isolated synovial osteochondromatosis inside a popliteal cyst is uncommon.
Journal of Medical Cases, Mar 17, 2012
Posterior dislocations of the humeral head are rare and often missed on initial presentation. Hal... more Posterior dislocations of the humeral head are rare and often missed on initial presentation. Half of these injuries are associated with an impression fracture of the anteromedial aspect of the humeral head (reverse Hill-Sachs lesion). Several operative strategies have been described to treat this injury, but evidence based management strategies are lacking. We describe a case in which a young and active patient presented with a stiff and painful shoulder following a clavicle fracture 9 months earlier. MRI revealed a locked posterior shoulder dislocation and large reverse Hill-Sachs defect. Anatomic reconstruction of the humeral head was performed using a femoral head allograft to fill the defect. A year later the patient has a good shoulder function without pain or impairments in his daily activities. Posterior shoulder dislocation continues to be a "diagnostic trap". This case reinforces the importance of radiographic axial and transscapular (Y) shoulder views to prevent missing the diagnosis. We state that, even in cases with delayed diagnosis and large humeral head defects, one should attempt to preserve the stability and function of the shoulder joint by restoring the normal anatomy of the humeral head. Femoral head allografting proves to be a suitable option. This case is unique in the combination of injuries, the long diagnostic delay and the encouraging functional results after femoral head allografting.
PubMed, Mar 1, 2014
Glenoid fractures are rare, and relatively little is known about their mechanism, fracture patter... more Glenoid fractures are rare, and relatively little is known about their mechanism, fracture pattern and optimal treatment strategies. The avulsions and rim fractures are strongly associated with anterior shoulder dislocations. Fossa fractures are mostly seen in high energy trauma patients as direct impact of the humeral head against the glenoid fossa. CT-scanning can be very useful in diagnosing the extend of injury and relation of humeral head with the main fragment of the glenoid. Fracture classification systems, have been designed mainly based on trauma mechanism, location and severity of fracture pattern. Treatment depends on instability, the degree of displacement and the articular surface fragment size, but is conservative in most cases. Due to the increase of arthroscopic fixation possibilities, operative treatment may increase. In this review, we have tried to summarize the available evidence into a treatment algorithm for different types of glenoid fractures. With regard to best functional outcome, an anatomical and concentric joint restoration should be the goal of treatment. Outcome is generally good in conservative and operative treatment, but exact data is difficult to appreciate, due to heterogeneity and comorbidities in different studies.
Occupational Medicine, Jul 20, 2023
Background Anatomic total shoulder arthroplasty (aTSA) and hemiarthroplasty (HA) have demonstrate... more Background Anatomic total shoulder arthroplasty (aTSA) and hemiarthroplasty (HA) have demonstrated significant improvement in shoulder function and pain relief. Work-related outcomes have become increasingly important, while the current literature lacks evidence related to return-to-work (RTW) and which factors might have an influence on it. Aims This study aimed to assess RTW in patients who have received aTSA or HA at a minimum of 1-year follow-up after surgery, and secondary to evaluate possible prognostic factors associated with RTW. Methods We performed a retrospective query in employed patients diagnosed with primary osteoarthritis of the shoulder, who received either an aTSA or HA between February 2006 and February 2021. Preoperative and post-operative work and sports participation were assessed. Results Forty-four patients participated in this study (98% compliance), of which 40 patients (91%) were able to RTW at a median time of two (interquartile range: 2–4) months post-operatively. Patients with a medium-/high-demand occupation demonstrated RTW at a significantly lower rate (79%) than those with light-demand occupations (100%; P = 0.03). There was a statistically significant association between return to full employment and patients’ expectation to fully return, absence of preoperative work adjustments and preoperative sick leave (odds ratio: 16.9 [3.1–93.5]; 18.3 [2.1–160.4]; 0.1 [0.0–0.6]). Conclusions aTSA and HA facilitate excellent RTW rates. Patients with a medium-/high-demand occupation return at a significantly lower rate. The ability to RTW seems to be multifactorial and the results found might not be attributed to shoulder arthroplasty alone.
Foot and Ankle Surgery, Sep 1, 2017
Ankle fractures are among the most common fracture types, and 10% of all ankle fractures lead to ... more Ankle fractures are among the most common fracture types, and 10% of all ankle fractures lead to accessory syndesmotic injury. An injury that is challenging in every respect is syndesmotic instability. Since the range of diagnostic techniques and the therapeutic options is extensive, it still is a controversial subject, despite the abundance of literature. This review aimed to summarize the current knowledge on syndesmotic instability in ankle fractures and to formulate some recommendations for clinical practice. Chronic instability and the operative osseous treatment of ankle fractures are not part of this review.
American Journal of Sports Medicine, Jun 1, 2015
Background: The high failure rate of rotator cuff repairs requires the development of methods to ... more Background: The high failure rate of rotator cuff repairs requires the development of methods to enhance healing at the tendonbone junction of the repair site. Purpose: To assess functional recovery and structural outcomes in detail after implanting recombinant human bone morphogenetic protein-12 (rhBMP-12)/absorbable collagen sponge (ACS) as adjuvant treatment during open rotator cuff repair in patients over a 1-year postoperative follow-up. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: A total of 20 patients were randomized into 2 groups, rhBMP-12/ACS and standard-of-care (SOC) control, with 16 and 4 patients, respectively. The patients underwent open repair of a rotator cuff tear at least 2 to 4 cm wide; in the rhBMP-12/ACS group, this was augmented with a bioscaffold containing rhBMP-12. Follow-up assessments were conducted with a 100-mm visual analog scale (VAS) for pain and active and passive ranges of motion (ROMs) including forward flexion, elevation in the scapular plane, abduction, and external rotation at 12, 16, 26, 39, and 52 weeks after surgery; isometric strength in scapular abduction and external rotation at 16, 26, 39, and 52 weeks; and magnetic resonance imaging (MRI) at 12 and 52 weeks. Results: The mean VAS score decreased from 37.9 mm preoperatively to 13.8 mm at week 52, and ROM and isometric strength recovered at week 52 in the rhBMP-12/ACS group. The mean VAS score decreased from 48.3 mm preoperatively to 1.5 mm at week 52, and ROM (excluding external rotation) and isometric strength recovered by week 52 in the SOC control group. Of the 16 patients in the rhBMP-12/ACS group, 14 showed an intact repair at week 12; the MRI scans of the other 2 patients could not be evaluated because of artifacts. In the SOC control group, 1 patient showed repair failure. At week 52, 14 repairs in the rhBMP-12/ ACS group and 2 repairs with available MRI scans in the SOC control group remained intact. Conclusion: Functional recovery and structural outcomes in patients in whom rhBMP-12/ACS was used as adjuvant therapy in rotator cuff repair justify conducting future, larger, multicenter, prospective studies.
Orthopaedic Journal of Sports Medicine, Sep 1, 2017
Background: The high failure rate of rotator cuff repairs requires the development of methods to ... more Background: The high failure rate of rotator cuff repairs requires the development of methods to enhance healing at the tendonbone junction of the repair site. Purpose: To assess functional recovery and structural outcomes in detail after implanting recombinant human bone morphogenetic protein-12 (rhBMP-12)/absorbable collagen sponge (ACS) as adjuvant treatment during open rotator cuff repair in patients over a 1-year postoperative follow-up. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: A total of 20 patients were randomized into 2 groups, rhBMP-12/ACS and standard-of-care (SOC) control, with 16 and 4 patients, respectively. The patients underwent open repair of a rotator cuff tear at least 2 to 4 cm wide; in the rhBMP-12/ACS group, this was augmented with a bioscaffold containing rhBMP-12. Follow-up assessments were conducted with a 100-mm visual analog scale (VAS) for pain and active and passive ranges of motion (ROMs) including forward flexion, elevation in the scapular plane, abduction, and external rotation at 12, 16, 26, 39, and 52 weeks after surgery; isometric strength in scapular abduction and external rotation at 16, 26, 39, and 52 weeks; and magnetic resonance imaging (MRI) at 12 and 52 weeks. Results: The mean VAS score decreased from 37.9 mm preoperatively to 13.8 mm at week 52, and ROM and isometric strength recovered at week 52 in the rhBMP-12/ACS group. The mean VAS score decreased from 48.3 mm preoperatively to 1.5 mm at week 52, and ROM (excluding external rotation) and isometric strength recovered by week 52 in the SOC control group. Of the 16 patients in the rhBMP-12/ACS group, 14 showed an intact repair at week 12; the MRI scans of the other 2 patients could not be evaluated because of artifacts. In the SOC control group, 1 patient showed repair failure. At week 52, 14 repairs in the rhBMP-12/ ACS group and 2 repairs with available MRI scans in the SOC control group remained intact. Conclusion: Functional recovery and structural outcomes in patients in whom rhBMP-12/ACS was used as adjuvant therapy in rotator cuff repair justify conducting future, larger, multicenter, prospective studies.
Knee Surgery, Sports Traumatology, Arthroscopy, Sep 4, 2020
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Papers by Arthur Van Noort