Peter Verdonk

Ghent University, Gand, Flemish, Belgium

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Publications (156)367.06 Total impact

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    Tim Spalding · Ben Parkinson · Nick A. Smith · Peter Verdonk
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    ABSTRACT: Meniscal allograft transplantation improves clinical outcomes for patients with symptomatic meniscus-deficient knees. We describe an established arthroscopic technique for meniscal allograft transplantation without the need for bone fixation of the meniscal horns. After preparation of the meniscal bed, the meniscus is parachuted into the knee through a silicone cannula and the meniscal horns are fixed with sutures through bone tunnels. The body of the meniscus is then fixed with a combination of all-inside and inside-out sutures. This technique is reliable and reproducible and has clinical outcomes comparable with those of bone plug fixation techniques.
    Full-text · Article · Oct 2015 · Arthroscopy Techniques
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    ABSTRACT: Meniscal tears are common injuries often treated by partial meniscectomy. This may result in altered joint contact mechanics which in turn may lead to worsening symptoms and an increased risk of osteoarthritis. Meniscal scaffolds have been proposed as a treatment option aimed at reducing symptoms while also potentially reducing progression of degenerative change. There are 2 scaffolds available for clinical use at the present time; Collagen Meniscus Implant and Actifit. Medium-term to long-term data (4.9 to 11.3 y) demonstrate efficacy of partial meniscus replacement. The patients who seem to benefit most are chronic postmeniscectomy rather than acute meniscal injuries. Herein we report on available clinical data for Collagen Meniscus Implant and Actifit while describing our preferred surgical technique and postoperative rehabilitation program.
    No preview · Article · Sep 2015 · Sports medicine and arthroscopy review
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    ABSTRACT: Treatment of osteochondral defects remains a challenge in orthopedic surgery. The TruFit plug has been investigated as a potential treatment method for osteochondral defects. This is a biphasic scaffold designed to stimulate cartilage and subchondral bone formation. The aim of this study is to investigate clinical, radiological, and histological efficacy of the TruFit plug in restoring osteochondral defects in the joint. We performed a systematic search in five databases for clinical trials in which patients were treated with a TruFit plug for osteochondral defects. Studies had to report clinical, radiological, or histological outcome data. Quality of the included studies was assessed. Five studies describe clinical results, all indicating improvement at follow-up of 12 months compared to preoperative status. However, two studies reporting longer follow-up show deterioration of early improvement. Radiological evaluation indicates favorable MRI findings regarding filling of the defect and incorporation with adjacent cartilage at 24 months follow-up, but conflicting evidence exists on the properties of the newly formed overlying cartilage surface. None of the included studies showed evidence for bone ingrowth. The few histological data available confirmed these results. There are no data available that support superiority or equality of TruFit compared to conservative treatment or mosaicplasty/microfracture. Further investigation is needed to improve synthetic biphasic implants as therapy for osteochondral lesions. Randomized controlled clinical trials comparing TruFit plugs with an established treatment method are needed before further clinical use can be supported.
    Full-text · Article · Jun 2015 · Cartilage
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    ABSTRACT: There are several surgical options for recurrent patella dislocations. As the reconstruction of the medial patellofemoral ligament (MPFL) has been proven to restore stability, it has become more accepted. Aim of this study was to investigate the clinical outcome after MPFL reconstruction as an isolated procedure or in association with a transposition of the tibial tubercle (in case of patella alta or an excessive TT-TG) in a large prospective cohort study. Additionally, the effect on patellar height was analysed radiographically using the Caton-Deschamps index. In a large prospective cohort study of 129 knees in 124 patients (81 females, 48 males, mean age 22.8 ± 7.7 years), 91 knees received primary MPFL reconstruction (group 1) and 38 were a combination with a transposition of the tibial tubercle (group 2). The clinical follow-up was evaluated using KOOS and Kujala scores preoperatively and 1 year postoperatively. Patient satisfaction, complications and revision surgery were recorded. Overall, Kujala improved significantly from 53.5 (SD 22.7) preoperatively to 74.7 (SD 20.5) postoperatively (p < 0.01). All KOOS subdomains improved significantly (p < 0.01). No significant difference for Kujala score between groups was noticed. Revision rate was (5/129) 3.9 %. Reconstruction was supplemented with a transfer of the tibial tuberosity in (38/129) 29.4 % of the cases and shows a comparable outcome. MPFL reconstruction is a viable treatment option for episodic patellar dislocation. A concomitant tuberositas transposition is useful in selected patients. I.
    No preview · Article · Jun 2015 · Knee Surgery Sports Traumatology Arthroscopy

  • No preview · Article · Apr 2015 · Acta orthopaedica Belgica

  • No preview · Article · Apr 2015 · Acta orthopaedica Belgica

  • No preview · Article · Apr 2015 · Acta orthopaedica Belgica
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    ABSTRACT: Trochlear dysplasia appears in different geometrical variations. The Dejour classification is widely used to grade the severity of trochlear dysplasia and to decide on treatment. To investigate the effect of trochlear dysplasia on patellofemoral biomechanics and to determine if different types of trochlear dysplasia have different effects on patellofemoral biomechanics. Controlled laboratory study. Trochlear dysplasia was simulated in 4 cadaveric knees by replacing the native cadaveric trochlea with different types of custom-made trochlear implants, manufactured with 3-dimensional printing. For each knee, 5 trochlear implants were designed: 1 implant simulated the native trochlea (control condition), and 4 implants simulated 4 types of trochlear dysplasia. The knees were subjected to 3 biomechanical tests: a squat simulation, an open chain extension simulation, and a patellar stability test. The patellofemoral kinematics, contact area, contact pressure, and stability were compared between the control condition (replica implants) and the trochlear dysplastic condition and among the subgroups of trochlear dysplasia. The patellofemoral joint in the trochlear dysplastic group showed increased internal rotation, lateral tilt, and lateral translation; increased contact pressures; decreased contact areas; and decreased stability when compared with the control group. Within the trochlear dysplastic group, the implants graded as Dejour type D showed the largest deviations for the kinematical parameters, and the implants graded as Dejour types B and D showed the largest deviations for the patellofemoral contact areas and pressures. Patellofemoral kinematics, contact area, contact pressure, and stability are significantly affected by trochlear dysplasia. Of all types of trochlear dysplasia, the models characterized with a pronounced trochlear bump showed the largest deviations in patellofemoral biomechanics. Investigating the relationship between the shape of the trochlea and patellofemoral biomechanics can provide insight into the short-term effects (maltracking, increased pressures, and instability) and long-term effects (osteoarthritis) of different types of trochlear dysplasia. Furthermore, this investigation provides an empirical explanation for better treatment outcomes of trochleoplasty for Dejour types B and D dysplasia. © 2015 The Author(s).
    Full-text · Article · Mar 2015 · The American Journal of Sports Medicine
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    ABSTRACT: The treatment of osteochondral lesions is of great interest to orthopaedic surgeons because most lesions do not heal spontaneously. We present the short-term clinical outcome and MRI findings of a cell-free scaffold used for the treatment of these lesions in the knee. A total of 38 patients were prospectively evaluated clinically for two years following treatment with an osteochondral nanostructured biomimetic scaffold. There were 23 men and 15 women; the mean age of the patients was 30.5 years (15 to 64). Clinical outcome was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Tegner activity scale and a Visual Analgue scale for pain. MRI data were analysed based on the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scoring system at three, 12 and 24 months post-operatively. There was a continuous significant clinical improvement after surgery. In two patients, the scaffold treatment failed (5.3%) There was a statistically significant improvement in the MOCART precentage scores. The repair tissue filled most of the defect sufficiently. We found subchondral laminar changes in all patients. Intralesional osteophytes were found in two patients (5.3%). We conclude that this one-step scaffold-based technique can be used for osteochondral repair. The surgical technique is straightforward, and the clinical results are promising. The MRI aspects of the repair tissue continue to evolve during the first two years after surgery. However, the subchondral laminar and bone changes are a concern. Cite this article: Bone Joint J 2015; 97-B:318-23. ©2015 The British Editorial Society of Bone & Joint Surgery.
    Full-text · Article · Mar 2015 · Bone and Joint Journal
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    ABSTRACT: PURPOSE: The purpose of this review was to evaluate the role of biological augmentation and tissue engineering strategies in meniscus surgery. Although clinical (human), preclinical (animal), and in vitro tissue engineering studies are included here, we have placed additional focus on addressing preclinical and clinical studies reported during the 5-year period used in this review in a systematic fashion while also providing a summary review of some important in vitro tissue engineering findings in the field over the past decade.
    No preview · Article · Feb 2015 · Arthroscopy The Journal of Arthroscopic and Related Surgery
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    ABSTRACT: This article looks into normal physiological fracture healing with special emphasis on the diamond concept. A precise definition of nonunion of long bones is described. Most often inadequate fixation (too rigid or too loose) is the reason for nonunion in long bone fractures. Because a critical bone defect cannot be bridged, it may lead directly or indirectly (lack of fixation) to nonunion. Individual inadequate local biological characteristics are also often found to be the cause; poor soft tissue coverage as well as a lack of periosteum and muscle or fascia or skin defects can lead to compromised vascularity in situ. Systemic factors are now much more recognized, e.g., smoking, diabetes, and cachexia, as well as the limited impact of some medications, e.g., nonsteroidal anti-inflammatory drugs and steroids. Today's mode of treatment for nonunion is approached in this article, and suggestions for appropriate treatment of long bone nonunion is presented.
    No preview · Article · Feb 2015 · Arthroscopy The Journal of Arthroscopic and Related Surgery
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    ABSTRACT: Aim: To perform a clinical and imaging short term evaluation of viable and frozen meniscus allografts. Methods and materials: Between 2005 and 2006, 12 meniscal allograft transplantations were performed in our institution. The study population consisted of 5 men and 7 women with a mean age of 36.4 years (range 17.1-42.5). Six patients received a viable allograft and six a deep-frozen one. All allografts were harvested from donors who died after a short disease. All patients were operated with an open surgical technique (medial or lateral arthrotomy) and soft tissue fixation with secure anterior and posterior horn fixation, performed by one senior surgeon. All patients were scored pre-operatively, at 6 weeks, 3 months, 6 months, 1 and 2 years postoperatively. Three questionnaires were used to score the patients clinically (KOOS, modified HSS and SF-36 questionnaire). Every patient received radiographs pre-operatively and at 6 months and 1 year. Results: Clinically, there was no difference in patient self-reported results through questionnaires or in a questionnaire based on clinical examination. There was no significant progress in joint space narrowing on weight bearing and Rosenberg view radiographs. Conclusion: Our results suggest that there are no clinical significant differences between the viable and the deep frozen subgroup after two years. © 2014, Croatian Medical Association and School of Medicine. All rights reserved.
    No preview · Article · Jan 2015 · Medicina Fluminensis
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    ABSTRACT: Purpose It remains unclear what the contribution of the PCL is in total knee arthroplasty (TKA). The goal of this study was to investigate the influence of the PCL in TKA in relationship to clinical outcome, strength and proprioception. Methods Two arthroplasty designs were compared: a posterior cruciate-substituting (PS) and a posterior cruciate-retaining (CR) TKA. A retrospective analysis was performed of 27 CR and 18 PS implants with a minimum of 1 year in vivo. Both groups were compared in terms of clinical outcome (range of motion, visual analogue scale for pain, Hospital for Special Surgery Knee Scoring system, Lysholm score and Knee Injury and Osteoarthritis Outcome Score), strength (Biodex System 3 Dynamometer®) and proprioception (balance and postural control using the Balance Master system®). Each design was also compared to the non-operated contralateral side in terms of strength and proprioception. Results There were no significant differences between both designs in terms of clinical outcome and strength. In terms of proprioception, only the rhythmic weight test at slow and moderate speed shifting from left to right was significant in favour of the CR design. None of the unilateral stance tests showed any significant difference between both designs. There was no difference in terms of strength and proprioception between the operated side and the non-operated side. Conclusion Retaining the PCL in TKA does not result in an improved performance in terms of clinical outcome and proprioception and does not show any difference in muscle strength. Level of evidence III.
    No preview · Article · Oct 2014 · Knee Surgery Sports Traumatology Arthroscopy
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    ABSTRACT: Background : Post-operative widening of tibial and/or femoral bone tunnels is a common observation after ACL reconstruction, especially with soft-tissue grafts. There are no studies comparing tunnel widening in hamstring autografts versus tibialis anterior allografts. The goal of this study was to observe the difference in tunnel widening after the use of allograft vs. autograft for ACL reconstruction, by measuring it with a novel 3-D computed tomography based method. Methods : Thirty-five ACL-deficient subjects were included, underwent anatomic single-bundle ACL reconstruction and were evaluated at 1 year after surgery with the use of 3-D CT imaging. Three independent observers semi-automatically delineated femoral and tibial tunnel outlines, after which a best-fit cylinder was derived and the tunnel diameter was determined. Finally, intra- and inter-observer reliability of this novel measurement protocol was defined. Results : In femoral tunnels, the intra-observer ICC was 0.973 (95% CI: 0.922-0.991) and the inter-observer ICC was 0.992 (95% CI: 0.982-0.996). In tibial tunnels, the intra-observer ICC was 0.955 (95% CI: 0.875 – 0.985). The combined inter-observer ICC 0.970 (95% CI:). Tunnel widening was significantly higher in allografts compared to autografts, in the tibial tunnels (p = 0.013) as well as in the femoral tunnels (p = 0.007). Conclusions : To our knowledge, this novel, semi-automated 3D-computed tomography image processing method has shown to yield highly reproducible results for the measurement of bone tunnel diameter and area. This series showed a significantly higher amount of tunnel widening observed in the allograft group at 1-year follow-up. Level of Evidence: Level II, Prospective comparative study
    Full-text · Article · Oct 2014 · The Knee
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    ABSTRACT: To investigate the biomechanical effect of skeletal knee joint abnormalities, the authors propose to implant pathologically shaped rapid prototyped implants in cadaver knee specimens. This new method was validated by replacing the native trochlea by a replica implant on four cadaver knees with the aid of cadaver-specific guiding instruments. The accuracy of the guiding instruments was assessed by measuring the rotational errors of the cutting planes (on average 3.01° in extension and 1.18° in external/internal rotation). During a squat and open chain simulation, the patella showed small differences in its articulation with the native trochlea and the replica trochlea, which could partially be explained by the rotational errors of the implants. This study concludes that this method is valid to investigate the effect of knee joint abnormalities with a replica implant as a control condition to account for the influence of material properties and rotational errors of the implant.
    Preview · Article · Aug 2014 · Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine
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    ABSTRACT: Purpose Meniscus replacement is of clinical benefit, but universal efficacy remains elusive. A greater understanding of the biological activity within implanted allografts or synthetic scaffolds may assist the development of improved surgical strategies. Materials Biopsies of fresh–frozen allograft (n = 20), viable allograft (n = 18) and polyurethane scaffolds (n = 20) were obtained at second-look arthroscopy. Histological evaluation of tissue morphology and cell density/distribution was performed using haematoxylin–eosin (H&E) staining. Immunohistochemistry was used to detect the presence of CD34 (on progenitor cells and blood vessels) and smooth muscle actin (SMA)-positive structures and aggrecan. Collagen presence was investigated using picrosirius red staining. Results Cell density in the deep zone of the meniscus replacement was significantly higher in polyurethane scaffolds versus allograft transplants (p
    Full-text · Article · Jul 2014 · International Orthopaedics
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    ABSTRACT: Objectives In this pilot study we wanted to evaluate the kinematics of a knee implanted with an artificial polycarbonate-urethane meniscus device, designed for medial meniscus replacement. The static kinematic behavior of the implant was compared to the natural medial meniscus of the non-operated knee. A second goal was to evaluate the motion pattern, the radial displacement and the deformation of the meniscal implant. Materials and Methods Three patients with a polycarbonate-urethane implant were included in this prospective study. An open-MRI was used to track the location of the implant during static weight-bearing conditions, within a range of motion of 0° to 120° knee flexion. Knee kinematics were evaluated by measuring the tibiofemoral contact points and femoral roll-back. Meniscus measurements (both natural and artificial) included anterior-posterior meniscal movement, radial displacement, and meniscal height. Results No difference (p > 0.05) was demonstrated in femoral roll-back and tibiofemoral contact points during knee flexion between the implanted and the non-operated knees. Meniscal measurements showed no significant difference in radial displacement and meniscal height (p > 0.05) at all flexion angles, in both the implanted and non-operated knees. A significant difference (p ≤ 0.05) in anterior-posterior movement during flexion was observed between the two groups. Conclusions In this pilot study, the artificial polycarbonate-urethane implant, indicated for medial meniscus replacement, had no influence on femoral roll-back and tibiofemoral contact points, thus suggesting that the joint maintains its static kinematic properties after implantation. Radial displacement and meniscal height were not different, but anterior-posterior movement was slightly different between the implant and the normal meniscus.
    Full-text · Article · Jul 2014 · Clinical Biomechanics
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    ABSTRACT: This study presents the prospective two-year clinical and MRI outcome of autologous matrix-induced chondrogenesis (AMIC) for the treatment of patellofemoral cartilage defects in the knee. Ten patients were clinically prospectively evaluated during 2 years. MRI data were analysed based on the original and modified MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) scoring system. A satisfying clinical improvement became apparent during the 24 months of follow-up. The MOCART scoring system revealed a slight tendency to deterioration on MRI between one and 2 years of follow-up. However, the difference was not statistical significant. All cases showed subchondral lamina changes. The formation of intralesional osteophytes was observed in 3 of the 10 patients (30%). In conclusion, AMIC is safe and feasible for the treatment of symptomatic patellofemoral cartilage defects and resulted in a clinical improvement. However, the favourable clinical outcome of the AMIC technique was not confirmed by the MRI findings.
    No preview · Article · Jun 2014 · Acta orthopaedica Belgica
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    ABSTRACT: This study was designed to describe the clinical and radiographical outcome of the HemiCAP(®) resurfacing system as a salvage treatment for a failed index cartilage procedure. Fourteen patients were treated consecutively and clinically prospectively followed for a mean period of 26.1 ± 12.8 months. All patients were previously treated for their cartilage lesion. Radiographical data were analysed based on the Kellgren and Lawrence system. The patients involved in this study demonstrated a gradual clinical improvement in time. However, radiographically significant osteoarthritic changes were observed during the follow-up period. The position of the HemiCAP(®) resurfacing system was adequate in all cases, and no signs of loosening were observed during the follow-up period. The HemiCAP(®) resurfacing system is feasible as a salvage treatment for a failed index cartilage procedure and resulted in a gradual clinical improvement. However, the favourable clinical outcome was not confirmed by the radiographical findings. LEVEL OF EVIDENCE: IV.
    Full-text · Article · Apr 2014 · Knee Surgery Sports Traumatology Arthroscopy
  • Onur Bilge · Koen Lagae · Francis Bonte · Rene Verdonk · Peter Verdonk
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    ABSTRACT: Recent articles have ranked Lateral Release (LR) 47th among all procedures by orthopaedic surgeons [ 9 , 14 ]. Despite its frequency the indications and results of an LR remain controversial. The acceptable results (good and excellent) have a wide range from 14 to 99 % [ 1 , 4 , 12 , 14 ]. LR can be subdivided as both an isolated and an associated procedure (as part of a proximal or distal realignment). The procedure can also be performed as an open, mini-open or arthroscopic procedure [ 14 ]. O'Neill et al. proved that there is no significant difference in outcome between arthroscopic and open LR [ 18 ]. In arthroscopic LR, however, the risk for postoperative hemarthrosis and swelling is considered higher. The use of electrocautery is advised to prevent this major complication. Until today, this study is the only prospective random-ized clinical trial concerning LR. 15.1.1 Anatomy of the Lateral Retinaculum The lateral retinaculum consists of two separate layers (Fig. 15.1): 1. The superfi cial oblique layer: This originates from the iliotibial band and interdigitates with the longitudinal fi bres of vastus lateralis. 2. The deep layer: This consists of the deep transverse retinaculum with the epicondylo-patellar ligament proximally and the patello-tibial ligament distally.
    No preview · Chapter · Mar 2014

Publication Stats

3k Citations
367.06 Total Impact Points

Institutions

  • 2003-2015
    • Ghent University
      • • Department of Rehabilitation Sciences and Physiotherapy
      • • Rheumatology
      Gand, Flemish, Belgium
  • 2005-2014
    • Universitair Ziekenhuis Ghent
      • Department of Rheumatology
      Gand, Flanders, Belgium
  • 2010-2012
    • Stedelijk Ziekenhuis Roeselare
      Rouselare, Flemish, Belgium
  • 2009
    • Oslo University Hospital
      Kristiania (historical), Oslo, Norway
  • 2008-2009
    • Hospices Civils de Lyon
      Lyons, Rhône-Alpes, France
  • 2007
    • Centre Hospitalier Universitaire de Lyon
      Lyons, Rhône-Alpes, France