Biographical background and origin of common eponymous terms in orthopedic surgery: anatomy and fractures in knee surgery.

An eponym is a person after whom an eponymous term is named. These eponymous terms are easy shorthand in communication between surgeons. Therefore, they are often used and hard to eradicate. We discuss eponymous terms that describe anatomical features and fracture types in the knee. With these terms, an overview of the historical background of the eponym and its current clinical implication is discussed. The eponymous terms discussed are Gerdy tubercle, Pellegrini-Stieda lesion, Segond fracture, Hoffa fracture and fat pad. The meaning of the eponymous term is clarified, the biography of the namegiver given and its contemporary clinical implication discussed. Since eponymous terms are used frequently in inter-collegial discussion and literature, the meaning should be clear for everyone, since otherwise it might give room for misunderstanding.

The Reliability of Orthopaedic Eponymous Terms.

BACKGROUND: There are approximately 20,000 medical eponymous terms in use today. Familiar eponymous terms serve as shorthand during communication with colleagues. This study tested the reliability of the everyday use of common orthopaedic eponymous terms. METHODS: Using an online survey, 224 orthopaedic surgeons were quizzed on common eponymous terms. The correspondence of each eponymous term with its original description (termed appropriate use) was calculated with 95% confidence intervals. We measured the reliability of the use of eponymous terms using the kappa statistic and the proportion of agreement. RESULTS: The percentage of appropriate use averaged 45% (ranging from 27% [for the Barton fracture eponymous term] to 75% [for the Sever's disease eponymous term]), with greater misuse among European surgeons. The reliability of the use of eponymous terms was low (kappa, 0.11; proportion of agreement, 68%). The support for using eponymous terms in daily practice was significantly lower among surgeons practicing in North America (63%) than among their colleagues in Europe and South America (80%; p < 0.001). Eponymous terms were used more often than anatomical descriptions or classifications. CONCLUSIONS: Using eponymous terms is an inaccurate and unreliable method of communication. Descriptive terms are preferable to eponymous terms.

Eponymous terms in daily practice: a survey among Dutch orthopedic surgeons.

INTRODUCTION: With a survey among Dutch orthopedic surgeons, we try to assess whether eponymous terms are still in use in daily practice. We also tried to find out whether younger generations tend to use them less than our older colleagues. MATERIALS AND METHODS: In a survey consisting of 57 eponymous terms, 67 participants were asked to mark the eponyms they knew and whether they used them in daily practice. RESULTS: No correlation was observed in known/used eponyms or years of experience in 58 completed surveys. Respondents who classified themselves as trauma or general orthopedic surgeons knew or used a significantly higher number of eponyms in daily practice than orthopedic surgeons who classified themselves as spine, upper limb, lower limb, sports or pediatric surgeons. DISCUSSION: Eponymous terms are used frequently in daily practice. Super-specialization might eradicate the general orthopedic surgeon, and the number of eponyms known and used might become smaller and more focused on the super-specialty. CONCLUSION: Our survey showed that eponymous terms are still used frequently in daily practice among both young and more senior orthopedic surgeons in The Netherlands.

Are eponyms used correctly or not? A literature review with a focus on shoulder and elbow surgery.

BACKGROUND: Eponymous terms are used frequently in daily patient care and scientific literature. They remind us of our predecessors in surgery. It is debatable whether eponymous terms are reliable in case of information transfer. The aim of our study was to investigate whether the original meaning of eponymous terms in shoulder and elbow surgery has been preserved in its use in contemporary literature. OBJECTIVE: To evaluate whether eponymous terms were used correctly, we analysed the use of frequently encountered eponymous terms from January to December 2014. STUDY SELECTION: By means of a PubMed search, articles with eponymous terms were identified and analysed for the way an eponymous term was used, and we compared it with the original description. The original description was traced back to the index publication. The use of the eponymous term was scored as similar, divergent or undefined. In the search for eponymous terms, we included those eponymous terms that were used more than 10 times in the English, German and Dutch literature of 2014. 6 eponymous terms were eligible for analysis: Bankart lesion, Bristow-Latarjet procedure, Essex-Lopresti injury of the forearm, Galeazzi fracture, Hill-Sachs lesion and Monteggia fracture. FINDINGS: We analysed 96 articles with the listed eponymous terms, of which 27 (28%) were scored divergent, 32 (33%) undefined and 37 (39%) similar. Bristow-Latarjet scored lowest, with 0% descriptions similar to the original, meaning that all articles had an undefined or divergent eponym, and Essex-Lopresti scored highest with 82% similarity. CONCLUSIONS: Eponymous terms in shoulder and elbow trauma and surgery are used inadequately and inconsistently. The use of eponymous terms probably cannot be avoided, but since the majority of eponymous terms are not used properly and understanding of its meaning and content varies from surgeon to surgeon, we should be keen on explaining the meaning of eponymous terms when using them.

Etiopathogenesis of osteolytic cysts associated with total ankle arthroplasty, a histological study.

BACKGROUND: Osteolytic cyst formation after total ankle arthroplasty has been identified in recent years and is probably an important problem with longer follow-up. The aim of this study is to describe the outcome of a histological analysis of samples from periprosthetic intra-osseous cysts and joint capsules, retrieved during revision surgery after primary total ankle arthroplasty. METHODS: All samples (n=22) were analyzed and scored using a semi-quantitative grading system. The main items of interest were polyethylene (PE) particles, metal particles, histiocytes, and giant cells. RESULTS: All cyst samples contained PE particles. A similar number of PE particles were found in talar and tibial cysts. No significant correlation between the number of PE particles and time to reoperation was found. Metal particles were found in 16 cysts. CONCLUSIONS: We suggest that PE particles are not the primary cause of osteolytic cyst formation but a secondary contributing factor probably accelerating the process of osteolysis. It is likely that implant design, biomechanical factors and local anatomic-physiological factors play an important role.

Total ankle replacement for posttraumatic arthritis. Similar outcome in postfracture and instability arthritis: a comparison of 90 ankles.

BACKGROUND AND PURPOSE: Most studies on total ankle replacement (TAR) have used a case mix of patients. We evaluated the outcome of TAR performed for end-stage arthritis either because of fracture or ligamentous injury. PATIENTS AND METHODS: We prospectively followed 88 consecutive patients (50 postfracture ankles and 40 ankles with instability arthritis (2 bilateral)) who underwent TAR between 2001 and 2009. Mean follow-up for both groups was 5 years. RESULTS: Preoperative varus deformity of 10° or more was present in 23 ankles in the instability group. At 6 years, survival with revision or salvage fusion as an endpoint was 87% (95% CI: 74-99) in the postfracture group and 79% (95% CI: 63-94) in the instability group. Progressive periprosthetic osteolysis was seen in 23 ankles, and required salvage fusion in 6. The number of reoperations was similar in both groups. Clinical outcome, as assessed with 2 ankle scores and 2 questionnaires, showed good results and was similar at the latest follow-up. INTERPRETATION: The outcome was similar in the postfracture and instability groups and also similar to that reported in series including a case mix of patients. In contrast to earlier reports, preoperative frontal plane deformity in this series was not identified as a risk factor for failure.