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The incidence of arthroscopic subacromial decompression has been increasing over the last few years. Little is known about the duration of sick leave after such a procedure. The aim of this study was to determine the time till return to full duty and to explore the various influencing factors. We retrospectively evaluated a group of 166 patients who consecutively underwent arthroscopic subacromial decompression for subacromial impingement syndrome. One hundred patients were professionally active at the time of surgery; the mean duration till return to full duty was 11.1 weeks. Self-employed workers had the shortest sick leave period (median time of 1 week). No statistically significant difference was seen between the group with a financial compensation from the national health insurance system (median time of 12 weeks) and the group with income replacement by a private insurance company (median time of 8 weeks). Patients performing manual labour typically had a longer period of sick leave than other employees (12 versus 8 weeks). A longer absence from work was also observed in individuals who underwent a concomitant arthroscopic AC resection and patients with a higher BMI.

This study aimed at systematic documentation of lateral knee pain in a consecutive series of 1102 cruciate-substituting, guided motion total knee arthroplasties (TKA) (Journey, Smith and Nephew, Memphis, TN, USA) performed in 1085 patients; 1070 knees were available for review. Follow-up time ranged from one to five years, with a mean of 2.5 years. Symptoms mimicking the well known iliotibial band (ITB) friction syndrome were observed in 77 knees (7.2%). Initial conservative treatment consisted of anti-inflammatory medication (77 knees) and local steroid injection (35 knees). The pain persisted in 22 knees (2%), leading to a surgical release of the iliotibial band. Other surgical interventions included revision for infection (6 knees, 0.5%), revision for tibial component loosening (6 knees, 0.5%), revision for tibiofemoral dislocation (3 knees, 0.3%), revision for patellar component loosening (5 knees, 0.4%), revision for instability (1 knee, 0.1%) and secondary patellar resurfacing (1 knee, 0.1%). The overall survivorship with partial or total implant revision as an endpoint was 98%. The development of lateral knee pain in association with the use of a guided motion design can be explained by the forced posterior translation of the lateral condyle in flexion. The asymmetric cam and post mechanism, acting as a hard driver of posterior femoral translation and internal tibial rotation during flexion, does not allow for the natural kinematic variability occurring in native knees. This repetitive and forced stretching of the ITB seems to induce a painful traction syndrome in some patients.

The purpose of this study was to determine the attitude of the members of the Flemish Elbow and Shoulder Surgeons Society (FLESSS) towards full-thickness tears of the rotator cuff and their treatment in their daily practice. A survey form was sent to 123 shoulder surgeons between January and March 2008. Seventy-three responses were returned, a 60% response rate. For 40% of the respondents, arthro-CT was the gold standard diagnostic method for assessment, 36% preferred arthro-MRI. Arthroscopic, mini-open and open cuff repair were preferred by 64%, 19% and 16% of the responders respectively. Fewer years in practice, a higher volume of shoulder operations and a higher volume of rotator cuff repairs were significantly correlated with a higher percentage of arthroscopic repairs (p > or = 0.001). With respect to the type of fixation, 91% preferred screw-type anchors, and of these 81% were metal anchors. Our results show that all-arthroscopic techniques are becoming the gold standard for the repair of full-thickness tears of the rotator cuff in Flanders.