{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:32:41Z","timestamp":1790901161515,"version":"4.1.0"},"reference-count":53,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,8,12]],"date-time":"2019-08-12T00:00:00Z","timestamp":1565568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,8,12]],"date-time":"2019-08-12T00:00:00Z","timestamp":1565568000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2019,8,12]],"date-time":"2019-08-12T00:00:00Z","timestamp":1565568000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,8,12]],"date-time":"2019-08-12T00:00:00Z","timestamp":1565568000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["arthroscopyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This review explores the current literature regarding both the clinical indications and utility of minimally invasive in\u2010office needle arthroscopy (IONA) relative to conventional imaging modalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In compliance with R\u2010AMSTAR (Revised Assessment of Multiple Systematic Reviews) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta\u2010analyses) guidelines, 3 databases (MEDLINE, Embase, and PubMed) were searched in July 2018, in addition to the conference abstract databases of 5 prominent meetings between 2013 and 2018, for studies using IONA for diagnostic purposes. Study quality was assessed with the Methodological Index for Non\u2010Randomized Studies (MINORS) criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 932 conference abstracts and 369 studies identified, 11 publications involving 404 patients (395 knees and 9 shoulders) were included, with 9 clinical studies and 2 cost analyses. The median Methodological Index for Non\u2010Randomized Studies (MINORS) score was 9 for noncomparative and 23 for comparative studies. Among the 9 clinical studies, IONA had a superior sensitivity, specificity, positive predictive value, and negative predictive value to magnetic resonance imaging (MRI) in the evaluation of knee osteoarthritis, anterior cruciate ligament insufficiency, and meniscal tears. IONA was comparable or inferior to MRI in the same parameters for the diagnosis of osteochondral defects and rotator cuff tears. In the 2 cost analyses, IONA had lower costs when used in place of MRI for treatment algorithms involving medial meniscal tears and rotator cuff tears but not lateral meniscal tears.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IONA holds potential for cost savings and improved diagnostic accuracy relative to MRI, primarily for intra\u2010articular meniscal, ligamentous, and chondral defects of the knee. However, its current indications for use in other joints are limited to rotator cuff tears in the shoulder, making its diagnostic value in other joints much more limited. The current quality and breadth of evidence are significantly lacking, with numerous practical shortcomings. To improve acceptance of IONA, priority should be placed on establishing defined protocols, indications, contraindications, and patient perspectives for the procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, systematic review of Level II, III, and IV studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2019.03.045","type":"journal-article","created":{"date-parts":[[2019,8,12]],"date-time":"2019-08-12T08:00:45Z","timestamp":1565596845000},"page":"2709-2721","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":65,"title":["In\u2010Office Needle Arthroscopy: A Systematic Review of Indications and Clinical Utility"],"prefix":"10.1002","volume":"35","author":[{"given":"Kailai","family":"Zhang","sequence":"first","affiliation":[{"name":"Michael G. DeGroote School of Medicine McMaster University Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael J.","family":"Crum","sequence":"additional","affiliation":[{"name":"Pittsburgh School of Medicine University of Pittsburgh Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Samuelsson","sequence":"additional","affiliation":[{"name":"Sahlgrenska Academy University of Gothenburg Goteborg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin","family":"Cadet","sequence":"additional","affiliation":[{"name":"Raleigh Orthopaedic Clinic Raleigh North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olufemi Rolland","family":"Ayeni","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery McMaster University Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren","family":"de SA","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery McMaster University Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,12]]},"reference":[{"key":"e_1_2_2_2_2","first-page":"286","article-title":"Assessment of correlation between MRI and arthroscopic pathologic findings in the shoulder joint","volume":"3","author":"Momenzadeh O.","year":"2015","journal-title":"Arch Bone Jt Surg"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.22271\/ortho.2017.v3.i3l.123"},{"key":"e_1_2_2_4_2","first-page":"252","article-title":"In\u2010office diagnostic needle arthroscopy: Understanding the potential value for the US healthcare system","volume":"46","author":"McMillan S.","year":"2017","journal-title":"Am J Orthop (Belle Mead NJ)"},{"key":"e_1_2_2_5_2","first-page":"883","article-title":"Appropriate use of MRI for evaluating common musculoskeletal conditions","volume":"83","author":"Pompan D.C.","year":"2011","journal-title":"Am Fam Physician"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2015150108"},{"key":"e_1_2_2_7_2","doi-asserted-by":"publisher","DOI":"10.1179\/2042618611Y.0000000009"},{"key":"e_1_2_2_8_2","unstructured":"Health Quality Ontario.Time to patient\u2019s first orthopedic surgical appointment. 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