@article{HeinzMellerLuetkensetal.2022,
  author    = {Heinz, Tizian and Meller, Felix and Luetkens, Karsten Sebastian and Horas, Konstantin and Sch{\"a}fer, Thomas and Rudert, Maximilian and Reppenhagen, Stephan and Weißenberger, Manuel},
  title     = {Can the MRI based AMADEUS score accurately assess pre-surgery chondral defect severity according to the ICRS arthroscopic classification system?},
  series = {Journal of Experimental Orthopaedics},
  volume    = {9},
  journal   = {Journal of Experimental Orthopaedics},
  number    = {1},
  issn      = {2197-1153},
  doi       = {10.1186/s40634-022-00511-w},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-300781},
  year      = {2022},
  abstract  = {Purpose The AMADEUS (Area Measurement And DEpth and Underlying Structures) scoring and grading system has been proposed for the MRI based evaluation of untreated focal chondral defects around the knee. The clinical practicability, its correlation with arthroscopically assessed grading systems (ICRS - International Cartilage Repair Society) and thereby its clinical value in terms of decision making and guiding prognosis was yet to determine. Methods From 2008 to 2019 a total of 89 individuals were indicated for high tibial valgus osteotomy (HTO) due to tibial varus deformity and concomitant chondral defects of the medial compartment of the knee. All patients received a preoperative MRI (1.5 Tesla or 3.0 Tesla) and pre-osteotomy diagnostic arthroscopy. Chondral defects of the medial compartment were scored and graded with the MRI based AMADEUS by three independent raters and compared to arthroscopic defect grading by the ICRS system. Interrater and intrarater reliability as well as correlation analysis with the ICRS classification system were assessed. Results Intraclass correlation coefficients for the various subscores of the AMADEUS showed an overall good to excellent interrater agreement (min: 0.26, max: 0.80). Intrarater agreement turned out to be substantially inferior (min: 0.08, max: 0.53). Spearman correlation revealed an overall moderate correlative association of the AMADEUS subscores with the ICRS classification system, apart from the defect area subscore. Sensitivity of the AMADEUS to accurately identify defect severity according to the ICRS was 0.7 (0.69 for 3.0 Tesla MRI, 0.67 for 1.5 Tesla MRI). The mean AMADEUS grade was 2.60 ± 0.81 and the mean ICRS score 2.90 ± 0.63. Conclusions Overall, the AMADEUS with all its subscores shows moderate correlation with the arthroscopic chondral grading system according to ICRS. This suggests that chondral defect grading by means of the MRI based AMADEUS is well capable of influencing and guiding treatment decisions. Interrater reliability shows overall good agreement.},
  language  = {en}
}
@article{WeissenbergerWagenbrennerSchoteetal.2022,
  author    = {Weißenberger, Manuel and Wagenbrenner, Mike and Schote, Fritz and Horas, Konstantin and Sch{\"a}fer, Thomas and Rudert, Maximilian and Barthel, Thomas and Heinz, Tizian and Reppenhagen, Stephan},
  title     = {The 3-triangle method preserves the posterior tibial slope during high tibial valgus osteotomy: first preliminary data using a mathematical model},
  series = {Journal of Experimental Orthopaedics},
  volume    = {9},
  journal   = {Journal of Experimental Orthopaedics},
  issn      = {2197-1153},
  doi       = {10.1186/s40634-022-00466-y},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-300806},
  year      = {2022},
  abstract  = {Purpose Despite much improved preoperative planning techniques accurate intraoperative assessment of the high tibial valgus osteotomy (HTO) remains challenging and often results in coronal over- and under-corrections as well as unintended changes of the posterior tibial slope. Noyes et al. reported a novel method for accurate intraoperative coronal and sagittal alignment correction based on a three-dimensional mathematical model. This is the first study examining preliminary data via the proposed Noyes approach for accurate intraoperative coronal and sagittal alignment correction during HTO. Methods From 2016 to 2020 a total of 24 patients (27 knees) underwent HTO applying the proposed Noyes method (Noyes-Group). Radiographic data was analyzed retrospectively and matched to patients that underwent HTO using the conventional method, i.e., gradual medial opening using a bone spreader under fluoroscopic control (Conventional-Group). All operative procedures were performed by an experienced surgeon at a single orthopaedic university center. Results From the preoperative to the postoperative visit no statistically significant changes of the posterior tibial slope were noted in the Noyes-Group compared to a significant increase in the Conventional-Group (p = 0.01). Regarding the axial alignment no significant differences between both groups were observed pre- and postoperatively. The number of over- and under-corrections did not differ significantly between both groups. Linear regression analysis showed a significant correlation of the postoperative medial proximal tibial angle (MPTA) with the position of the weightbearing line on the tibial plateau. Conclusion The 3-triangle method by Noyes seems to be a promising approach for preservation of the posterior tibial slope during HTO.},
  language  = {en}
}