Proximal anterior cruciate ligament tears: the healing response technique versus conservative treatment

The healing response technique (HRT) is a nonreconstructive method to promote healing in proximal anterior cruciate ligament (ACL) tears. The study reviews clinical and radiological long-term results. Thirty patients (average age 31 years) were treated according to the protocol described by Steadman et al. For comparison, an age- and gender-matched control group of conservatively treated patients (CST; n = 127) was selected. At follow-up (mean: 4 years), all patients were evaluated using Kneelax-3-arthrometer, magnetic resonance imaging (MRI), and by clinical examination. Two HRT patients were lost to follow-up and 10 (36%) patients needed definitive ACL reconstruction. The rate of secondary ACL reconstruction in the initial CST group was 56% (71 of 127). Nineteen of the conservatively treated patients were selected according to above-mentioned criteria. The average Lysholm score in the HRT group was 91 (CST group = 90), and the Orthopaedische Arbeitsgemeinschaft Knie score was 93 (CST group = 92). Tegner score decreased from 6.8 before injury to 5.7 at the time of follow-up (CST group: 6.0 to 5.1). Kneelax-3-arthrometer showed a significant higher anterior knee laxity compared with the noninjured side in both groups. MRI showed improvement of the ACL in both groups. HRT in adult patients is associated with a high revision rate of 36% secondary ACL reconstruction, comparable with primary conservative treatment (p = 0.056). For the remaining patients (64%), HRT did not result in better outcomes than conservative treatment

Landmark-Based Generation of Common Ultrasound Views and 17-Segment Model from Cardiac Computed Tomography

Complex medical therapies can require a multitude of imaging modalities and are often supervised by a team with different medical backgrounds. This necessitates the conversion of medical data between technical systems and visualizations. In the case of stereotactic arrhythmia radioablation therapy (STAR-therapy) of the left ventricle, electroanatomical mapping, ultrasound (US) and computed tomography (CT) are the central imaging modalities that are needed for defining the target volume as well as for the examination and validation pre and post treatment. In the interest of developing a motion management system for STAR-therapy, a way to transfer information and visualizations between these modalities and to compare data from different patients is needed. For this purpose, we present a landmark-based approach for the generation of commonly used ultrasound views and the 17-segment model from cardiac computed tomography (CCT) data. The developed tool can already be used to aid the examination process by extracting function-based views from CT datasets, comparing them to live US imaging, localize CT structures within the 17-segment model or to transfer information like motion or strain data from one modality to the other. In the future, it will be used in the development of a live or predictive management system for cardiac and respiratory motion