
Pieter CaekebekeZiekenhuis Oost Limburg | ZOL · Orthopaedics
Pieter Caekebeke
MD PhD
About
58
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Introduction
Current research for PhD at Hasselt University: 'The distal biceps tendon: from diagnosis to treatment'.
Skills and Expertise
Publications
Publications (58)
Radiocapitellar arthroplasty has been shown to improve pain and function in patients with a degenerative joint. Due to problems with the loosening of the radial head component, one of the few available systems was removed from the global market. This offered specific challenges in terms of treatment strategies when one or both components of a syste...
Partial distal biceps tendon tears encompass a spectrum of disease. They can be either traumatic or degenerative in nature. Traumatic tears usually involve the short head. Degenerative tears can involve either or both short and long head components with the tear affecting the lateral fibres first. Chronic tears may be associated with a narrow radio...
The goal of the present study was to evaluate the incidence of infection after perioperative intra-articular steroid injection during elbow arthroscopy. Starting from May 2019, we prospectively included all patients that underwent an elbow arthroscopy for various indications. All patients received preoperative antibiotics intravenously and a cortic...
Forearm rotation is essential for daily activities and functional dexterity, involving both pronation and supination. Forearm rotation limitations can result from various pathologies, often linked to trauma, structural changes in radio-ulnar joints, and interosseous membrane alterations. Soft tissue contracture, such as post-burn scarring or specif...
Introduction
Time-efficiency of individually wrapped screws versus screws in a screw rack is not well established.
Materials and methods
We performed a prospective single-center clinical study timing the interval between the surgeon asking and receiving a screw during plate and screw osteosynthesis of distal radius fractures. Patients were randomi...
Biohacking is a term used to describe people making changes to their bodies to improve their well-being. This includes the implantation of radiofrequency identification implants. This technology for wireless communication is already incorporated into our daily lives as in the use of contactless payment and badges to open doors. Since the first radi...
We present a case of fracture of the polyethylene liner of a dual-mobility trapeziometacarpal total joint arthroplasty. Standard radiographic imaging was normal. This case highlights the importance of dynamic radiographic imaging to make a timely diagnosis.
Complete distal biceps tendon ruptures are relatively uncommon. Conservative treatment may result in persistent pain and weakness. Therefore, surgical repair is usually indicated in order to restore strength. Different surgical techniques and fixation methods have been described. The most reported complications after surgery are iatrogenic nerve da...
Fractures of the phalanges may result in a challenging complication known as malrotation, which can adversely affect the functionality of the fingers during flexion, leading to scissoring. The standard surgical approach for correcting this condition involves open corrective osteotomy and derotation, often at the level of the metacarpal, which inclu...
In recent years, arthroscopy has become a valid option in the diagnosis and treatment of elbow instability. Both fractures and soft tissue lesions, as well as other associated lesions can be addressed. The diagnosis and arthroscopic treatment of both acute and chronic elbow instability are discussed in this paper.
The flexor pollicis longus tendon is prone to attritive rupture and retraction. Direct repair is often not possible. Interposition grafting is a treatment option to restore tendon continuity, although the surgical technique and postoperative results have not been well defined. We report our experience with this procedure. 14 patients were prospecti...
The aim of this study was to measure cortex thickness and medullar canal width of the bicipital tuberosity, to evaluate the accessibility of a intramedullar fixation device and the resistance to pullout strengths of the anterior cortex. The final objective was to determine the length of tendon ingrowth size that will be expected when using this sur...
Purpose
Magnetic resonance imaging (MRI) is used widely for complete ruptures of the distal biceps tendon. The validity of this investigation for bicipital bursitis and tendinosis is unknown. The purpose of present study was to assess the prevalence of incidental (asymptomatic) signal changes in the distal biceps tendon in patients who underwent MR...
Background
Intramedullary fixation in distal biceps tendon repair has been proposed to address specific shortcomings of current fixation techniques. Previous studies described a non-anatomical repair.
Hypothesis
The purpose of the present study is to report the short-term outcomes of an anatomic intramedullary fixation.
Study Design
We evaluated...
A 56-year-old woman presented with flexion dysfunction of the fifth digit 6 weeks after surgical repair of a flexor digitorum profundus laceration. She was scheduled for surgical adhesiolysis and restoration of the functionality of the finger. Intraoperative monitoring of the range of motion by active flexion was deemed important to prevent incompl...
Scaphoidectomy and 4-corner arthrodesis is a common salvage surgery for degenerative wrist pathology. The purpose of this study was to evaluate the results of this procedure performed with headless compression screws, with a special focus on postoperative com- plications and their treatment. We assessed 36 wrists in 31 patients that were treated be...
Background
The clinical diagnosis of partial distal biceps tendon ruptures or tendinosis can be challenging. Three clinical tests have been described to aid in an accurate and timely diagnosis: the biceps provocation test, the TILT sign and the resisted hook test. However, not much is known about the sensitivity, specificity and inter-rater reliabi...
Acute distal biceps tendon (DBT) pathology includes bicipitoradial bursitis, tendinosis, partial and complete tears. Diagnosis of complete DBT tears is mainly clinical, whereas in partial tears medical imaging is a valuable addition to the clinical diagnosis. New insights in clinical and medical imaging of partial tears may reduce time to diagnosis...
Background
Intramedullar fixation in distal biceps tendon repair may be a solution to address specific shortcomings of current fixation techniques. Most investigations are limited to biomechanical evaluation. The purpose of the present study was to report the short-term outcomes of an intramedullar fixation device.
Methods
We evaluated functional...
Postoperative rehabilitation plays a crucial role in the treatment of elbow pathology. Depending on the type of surgery, the elbow may need to be protected. As a general rule, the elbow should not be immobilized for a prolonged period after surgery. A removable splint can be used to protect the soft-tissues immediately postoperative and the patient...
Metacarpal fractures can be complicated by malrotation. This can cause functional problems with overriding or underriding of the fingers with flexion. Surgical treatment consists of corrective osteotomy and derotation. This is typically performed open and different techniques for osteotomy and fixation have been described. Postoperative complicatio...
Purpose
To describe and study a test for distal biceps tendon pathology other than complete tears.
Methods
In this prospective study, the biceps provocation test (BPT) was performed in a cohort of 30 patients with suspected distal biceps tendon pathology and 30 patients with another elbow pathology. Patients with a complete tear were excluded. Dia...
Background Corrective osteotomies of the proximal phalanx are typically stabilized with plate and screws. Although intramedullary headless screws form an alternative fixation method in the treatment of acute phalangeal fractures, reports about fixation of opening wedge corrective osteotomies with these implants are lacking.
Objective The goal of th...
Clinical results of endoscopic distal biceps tendon repair have been shown to be comparable to open techniques in small series. This study evaluates safety and accuracy of the endoscopic technique. Sixteen fresh-frozen paired cadaveric upper extremities were used. The distal biceps tendons were cut and then repaired with the classic single incision...
Background
Partial biceps tendon pathology is difficult to diagnose. The Flexion Abduction Supination (FABS) view MRI has been advocated to improve the accuracy of MRI investigation.
Hypothesis
The purpose of the present study is to evaluate the accuracy of the FABS view MRI in the diagnosis of distal biceps tendon pathology.
Methods
50 patients...
It has been suggested that trapeziometacarpal total joint arthroplasty be combined with complete release of the joint capsule to prevent ligament tethering and implant dislocation. Our goal was to evaluate the consequences of capsular release on range of motion. Trapeziometacarpal joint motion was measured with a 3D motion tracking system in seven...
Background
Various techniques have been described for distal biceps tendon reinsertion. Although high success rates have been reported, all current techniques have specific shortcomings, with complications such as heterotopic ossification, nerve damage, and gap formation. The purpose of the present study was to biomechanically evaluate a new intram...
Partial meniscectomy is a frequently performed treatment strategy for non-suturable meniscal tears. However, the meniscal volume which can be resected without compromising the load-bearing, shock-absorbing function of the meniscus remains a topic of ongoing research. The aim of this study was to calculate the medio-lateral meniscal volume ratio to...
Radiocarpal impingement after PRC is a well-known complication due to impingement of the radial styloid against the radial carpal bones. A less common impingement syndrome is that of the pisiforme. We describe a radiohamate impingement and its diagnosis and treatment. Based on a case we saw at our practice. Diagnosis is bases on standard radiograph...
Distal biceps endoscopy can be performed with different techniques. The technique described in this chapter is an adaptation of the technique described by Eames et al. and is indicated in both partial as complete distal biceps tendon tears. The patient is placed in supine position with the arm on an arm table, and a 2 cm longitudinal incision is ma...
Acute distal biceps tendon reinsertion is the treatment of choice in distal biceps tendon tears. We prefer to use a single 2-cm incision approach and fix the biceps tendon in a bone tunnel with a bicortical Endobutton. The original Bain technique was adapted and will be described in this chapter. The patient is placed in supine position with the ar...
Objectives / Interrogation: It has been suggested that in trapeziometacarpal total joint arthroplasty, the trapezial cup should be positioned parallel to the proximal articular surface of the trapezium (PAST). This suggestion was based on radiographic measurement of the range of motion of healthy joints. The goal of this study was to biomechanicall...
Objectives / Interrogation: Background:
Malunions of phalangeal fractures of the hand form a real challenge to the treating surgeon. Corrective osteotomies of the proximal phalanx need stable fixation to allow immediate active finger motion to prevent postoperative tendon adhesions. Typically this is achieved with plate/screw osteosynthesis . Des...
It has been suggested that the cup of a trapeziometacarpal total joint replacement should be positioned parallel with the proximal articular surface of the trapezium to align it with the centre of motion. This would diminish the chance of dislocation. The goal of this study was to test this idea biomechanically. A linked trapeziometacarpal prosthes...
Biceps tendon ruptures can be classified as acute or chronic and can be partial or complete. The diagnosis of a complete rupture is a clinical one and early surgical reinsertion is usually recommended. Diagnosing and treating a partial tear is often more complex. Ultrasound and magnetic resonance imaging offer additional information, but it may sti...
The most important complications of trapeziometacarpal arthroplasty are dislocation and component loosening. Incorrect cup position is often a contributing factor. Intra-operative guidelines to optimize cup orientation have recently been described. We evaluated the functional and radiological outcome of 50 Maïa® trapeziometacarpal prostheses that w...
Posterolateral rotatory instability (PLRI) describes a pattern of ligamentous instability in which the proximal ulna and radial head externally rotate about the distal humerus when the forearm is positioned in supination and slight flexion. Insufficiency of both the static ligamentous stabilizers and the dynamic stabilizers of the posterolateral el...
Chronic posterolateral rotatory instability (PLRI) is the most common form of chronic elbow instability.
PLRI usually occurs from a fall on the outstretched hand. On impact, the radial head and ulna rotate externally coupled with valgus displacement of the forearm. This leads to posterior displacement of the radial head relative to the capitellum,...
Purpose:
One of the options to repair a ruptured distal biceps tendon to the radial tuberosity is by means of a transosseous cortical button. Although excellent functional outcomes have been reported, no studies have been performed to quantify the effect of the transosseous fixation technique on the radius. Our study evaluated the clinical outcome...
Background:
Distal biceps tendon repair to the radial tuberosity can be conducted by means of an interference screw in combination with a transosseous button. Bioabsorbable interference screws have been associated with complications such as severe osteolytic reactions. We questioned whether patients with a distal biceps tendon repair with bioabsor...
In trapeziometacarpal arthroplasty, correct implant position may be necessary to prevent complications such as dislocation, component loosening and premature wear. The metacarpal stem more easily fits anatomically. However, the cup in the trapezium is not anatomical and guidelines for its orientation are not uniformly defined. We determined the cen...
The authors conducted a retrospective study comparing the corrective effect of two sublaminar techniques on scoliosis: the classical one, based on metal wire, and a more recent one, based on polyester tape (thoracic Universal Clamp), known to be safer (less risk of neurological damage, less laminar breakthrough) and compatible with MRI. Lumbar scre...
Pyoderma gangrenosum (PG) is a rare noninfectious neutrophilic dermatosis. Its course can be mild or malignant, chronic or relapsing with remarkable morbidity. We describe a case of PG, which presented with severe wound breakdown following a closed tibial plateau fracture of the left knee. Two weeks after the trauma, the patient developed ulcers in...