Subsequent Surgery After Revision Anterior Cruciate Ligament Reconstruction: Rates and Risk Factors From a Multicenter Cohort

BACKGROUND: While revision anterior cruciate ligament reconstruction (ACLR) can be performed to restore knee stability and improve patient activity levels, outcomes after this surgery are reported to be inferior to those after primary ACLR. Further reoperations after revision ACLR can have an even more profound effect on patient satisfaction and outcomes. However, there is a current lack of information regarding the rate and risk factors for subsequent surgery after revision ACLR. PURPOSE: To report the rate of reoperations, procedures performed, and risk factors for a reoperation 2 years after revision ACLR. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: A total of 1205 patients who underwent revision ACLR were enrolled in the Multicenter ACL Revision Study (MARS) between 2006 and 2011, composing the prospective cohort. Two-year questionnaire follow-up was obtained for 989 patients (82%), while telephone follow-up was obtained for 1112 patients (92%). If a patient reported having undergone subsequent surgery, operative reports detailing the subsequent procedure(s) were obtained and categorized. Multivariate regression analysis was performed to determine independent risk factors for a reoperation. RESULTS: Of the 1112 patients included in the analysis, 122 patients (11%) underwent a total of 172 subsequent procedures on the ipsilateral knee at 2-year follow-up. Of the reoperations, 27% were meniscal procedures (69% meniscectomy, 26% repair), 19% were subsequent revision ACLR, 17% were cartilage procedures (61% chondroplasty, 17% microfracture, 13% mosaicplasty), 11% were hardware removal, and 9% were procedures for arthrofibrosis. Multivariate analysis revealed that patients aged <20 years had twice the odds of patients aged 20 to 29 years to undergo a reoperation. The use of an allograft at the time of revision ACLR (odds ratio [OR], 1.79; P = .007) was a significant predictor for reoperations at 2 years, while staged revision (bone grafting of tunnels before revision ACLR) (OR, 1.93; P = .052) did not reach significance. Patients with grade 4 cartilage damage seen during revision ACLR were 78% less likely to undergo subsequent operations within 2 years. Sex, body mass index, smoking history, Marx activity score, technique for femoral tunnel placement, and meniscal tearing or meniscal treatment at the time of revision ACLR showed no significant effect on the reoperation rate. CONCLUSION: There was a significant reoperation rate after revision ACLR at 2 years (11%), with meniscal procedures most commonly involved. Independent risk factors for subsequent surgery on the ipsilateral knee included age <20 years and the use of allograft tissue at the time of revision ACLR

An Investigation of the Item Stability of the Mathematics Anxiety Rating Scale (Mars) : A Study of the Individual and Group Reliability Components of the Mars

A review of the literature concerning the Mathematics Anxiety Rating Scale (MARS) revealed that the MARS is currently being employed as a measure of therapy progress despite a lack of conclusive research to justify this procedure. Many scales of a similar nature have experienced considerable variability when used as a gauge of therapy progress. In addition, considerable pre- to posttest variability within the MARS had been previously reported. The purposes of this study were to identify these sources of variability, and attempt to stabilize the MARS by manipulating the serial order of the items. Three experimental versions of the MARS were employed: the original MARS (MARS-O), a reversed item sequence version (AARS-R), and a stratified version (MARS-S). Each version was administered according to standard instructions on the pretest, and re-administered four weeks later. Results showed a significant pre- to posttest reduction of group scores on the MARS-O and the MARS-S. Female Ss scored consistently higher than male Ss, and also demonstrated a significant pre- to posttest change on each of the three scale versions. Considerable item scoring and item discrimination variability was noted both within and across scales. Although the test-retest reliability of each of the scale versions was comparable to previously reported MARS data. The individual indices of change suggested a more pronounced variability than the group statistics implied. Attempts to stabilize the MARS through item manipulation were not successful. Implementation of the MARS as a pre- to posttest index of therapy change was not supported by this study

Considerando cómo utilizar los principales principios de la instrucción y las tecnologías de vídeo para apoyar el aprendizaje profesional de los maestros en educación matemática

Merrill’s First Principles of Instruction provide a framework for the design of learner-centered instruction. In this article we examine how those Principles of Instruction provide a framework to examine effective ways to leverage the use of video technologies to enhance the design and implement professional learning for mathematics teachers. We synthesize the First Principles of Instruction, the Launch-Explore-Discuss lesson cycle in mathematics (Polly, 2017b; Tools4NCTeachers, n.d.), and principles of learner-centered professional learning (Polly & Hannafin, 2010). We then describe vignettes about how video technologies can enhance professional learning experiences that align to the First Principles of Instruction and learner-centered professional learning. We close with implications and recommendations for research and practice for future endeavorsLos principales principios de instrucción de Merrill proporcionan un marco para el diseño de instrucción centrada en el alumno. En este artículo examinamos cómo esos Principios de Instrucción proporcionan un marco para examinar formas efectivas de aprovechar el uso de tecnologías de video para mejorar el diseño e implementar el aprendizaje profesional para los profesores de matemáticas. Sintetizamos los Primeros Principios de la Instrucción, el ciclo de lecciones Launch-Explore-Discuss en matemáticas (Polly, 2017b; Tools4NCTeachers, s.f.), y los principios del aprendizaje profesional centrado en el alumno (Polly y Hannafin, 2010). Luego describimos viñetas sobre cómo las tecnologías de video pueden mejorar las experiencias de aprendizaje profesional que se alinean con los Primeros Principios de Instrucción y el aprendizaje profesional centrado en el alumno. Cerramos con implicaciones y recomendaciones para la investigación y la práctica para futuros esfuerzo

The cognitive demands of student-centered, web-based multimedia: Current and emerging perspectives

This chapter examines the cognitive demands of student-centered learning from, and with, Web-based multimedia. In contrast to externally-structured directed learning, during the student-centered learning, the individual assumes responsibility for determining learning goals, monitoring progress toward meeting goals, adjusting or adapting approaches as warranted, and determining when individual goals have been adequately addressed. These tasks can be particularly challenging in learning from the World Wide Web, where billions of resources address a variety of needs. The individual, in effect, must identify which tools and resources are available and appropriate, how to assemble them, and how to manage the process to support unique learning goals. We briefly analyze the applicability of current cognitive principles to learning from Web-based multimedia, review and critically analyze research and practice specific to student-centered learning from Web-based multimedia, and describe implications for research. © 2009, IGI Global

Community involvement and the Commonside Community Development Trust.

The Commonside Trust is a non-profit community organization devoted to developing the Commonside area, located in the London borough of Merton. Because of limited staff, the Trust has been unable to devote resources to increase its volunteer base and community awareness of its programs. The purpose of this study was (1) to gather and present information to the Trust about attitudes towards volunteering, and (2) to provide technical support (a website review and a database) that will aid their efforts to increase volunteers and community involvement

The Handbook of Research on Educational Communications and Technology 3rd ed.

Robert Hannafin (with Michael F. Young) is a contributing author, Research in Technology , p. 730-739 Book description: Sponsored by the Association of Educational Communication and Technology (AECT), the third edition of this groundbreaking Handbook continues the mission of its predecessors: to provide up-to-date summaries and syntheses of recent research pertinent to the educational uses of information and communication technologies. In addition to updating, this new edition has been expanded from forty-one to fifty-six chapters organized into the following six sections: foundations, strategies, technologies, models, design and development, and methodological issues.https://digitalcommons.fairfield.edu/education-books/1043/thumbnail.jp