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ABSTRACT: The evaluation of quality of life is an established criterion for evaluation of therapeutic measures. Starting from the English-speaking area a great number of different patient-based outcomes measures were developed to specifically question disorders of the musculoskeletal system and the results of treatment. Because of the lack of a German measurement tool for patients with rotator cuff disease the translation and the psychometric testing following international guidelines of the 34-item, multidimensional, English Rotator Cuff Quality-of-Life Measure (RC-QOL) was undertaken. Reliability (test-retest reliability, internal consistency), validity, practicability and acceptance of the German version of the RC-QOL were tested by 102 patients with an impingement syndrome after translation and cross-culture adaptation of the English original questionnaire. In addition, the SF-36, the Constant and UCLA scores were evaluated. Between the evaluations there was no significant difference; the Pearson correlation coefficient was 0.89 for the test-retest reliability. The internal consistency showed a high homogeneity with a Cronbach Alpha-coefficient of 0.98. A Pearson correlation coefficient between 0.67-0.76 registered a high correlation with the physical subscales of the SF-36, the Constant and the UCLA scores. The mean time required for completing the RC-QOL was 12 minutes; mean time required for evaluation was 10 minutes. The questionnaire was incompletely answered by 16 patients (15.6%). A total of 120 items (3.5%) were left unanswered. After successful translation and psychometric testing of the German version of the Rotator Cuff Quality-of-Life Measure (RC-QOL) a multidimensional measurement tool for evaluating the quality of life of German-speaking patients with pathology of the rotator cuff is available.
Zeitschrift für Rheumatologie 05/2005; 64(3):188-97. · 0.46 Impact Factor
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ABSTRACT: Die Beurteilung der Lebensqualitt eines Patienten stellt ein zunehmendes Kriterium zur Bewertung von Behandlungsverfahren dar. Der vom angloamerikanischen Raum ausgehende Prozess fhrte zur Entwicklung einer Vielzahl verschiedener Messinstrumente, die auch spezifisch Erkrankungen des muskuloskelettalen Apparates und deren Therapieverlauf evaluieren. Mangels eines deutschsprachigen Messinstrumentes fr Patienten mit pathologischen Vernderungen der Rotatorenmanschette, soll die bersetzung und psychometrische Austestung des 34-Item umfassenden, multidimensionalen, englischsprachigen Rotator Cuff Quality-of-Life Measure (RC-QOL) nach internationalen Richtlinien erfolgen.Nach bersetzung und Cross-Culture-Adaptation des englischen Originals wurde die Reliabilitt (Test-Retest-Reliabilitt, interne Konsistenz), die Validitt, die Praktikabilitt und Akzeptanz der deutschen Version des RCQOL an 102 Patienten mit einer Impingementsymptomatik geprft. Zustzlich wurden der SF-36, der Constant- und der UCLA-Score an allen Patienten erhoben.Der Pearson-Korrelationskoeffizient war mit 0,89 ausreichend hoch fr die Test-Retest-Reliabilitt, zwischen beiden Erhebungen zeigte sich kein signifikanter Unterschied. Die interne Konsistenz erbrachte mit einem Cronbach-Alpha-Koeffizienten von 0,98 eine hohe Homogenitt. Der Pearson-Korrelationskoeffizient wies mit Werten von 0,67–0,76 eine hohe Korrelation mit den physischen Subskalen des SF-36, dem Constant- und UCLA-Score auf. Die durchschnittliche Zeit zur Beantwortung des RC-QOL lag bei 12 Minuten, zur Auswertung wurden 10 Minuten bentigt. 16 Patienten (15,6%) fllten den Fragebogen unvollstndig aus, insgesamt blieben 120 Einzelfragen (3,5%) unbeantwortet.Nach erfolgreicher bersetzung und psychometrischer Austestung der deutschsprachigen Version des Rotator Cuff Quality-of-Life Measure (RC-QOL) steht nun ein multidimensionales Messinstrument zur Erhebung der Lebensqualitt von deutschsprachigen Patienten mit einer pathologischen Vernderung an der Rotatorenmanschette zur Verfgung.The evaluation of quality of life is an established criterion for evaluation of therapeutic measures. Starting from the English-speaking area a great number of different patient-based outcomes measures were developed to specifically question disorders of the musculoskeletal system and the results of treatment. Because of the lack of a German measurement tool for patients with rotator cuff disease the translation and the psychometric testing following international guidelines of the 34-item, multidimensional, English Rotator Cuff Quality-of-Life Measure (RC-QOL) was undertaken. Reliability (test-retest reliability, internal consistency), validity, practicability and acceptance of the German version of the RC-QOL were tested by 102 patients with an impingement syndrome after translation and cross-culture adaptation of the English original questionnaire. In addition, the SF-36, the Constant and UCLA scores were evaluated. Between the evaluations there was no significant difference; the Pearson correlation coefficient was 0.89 for the test-retest reliability. The internal consistency showed a high homogeneity with a Cronbach Alpha-coefficient of 0.98. A Pearson correlation coefficient between 0.67–0.76 registered a high correlation with the physical subscales of the SF-36, the Constant and the UCLA scores. The mean time required for completing the RC-QOL was 12 minutes; mean time required for evaluation was 10 minutes. The questionnaire was incompletely answered by 16 patients (15.6%). A total of 120 items (3.5%) were left unanswered. After successful translation and psychometric testing of the German version of the Rotator Cuff Quality-of-Life Measure (RC-QOL) a multidimensional measurement tool for evaluating the quality of life of German-speaking patients with pathology of the rotator cuff is available.
Zeitschrift für Rheumatologie 03/2005; 64(3):188-197. · 0.46 Impact Factor
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ABSTRACT: To determine the prevalence and clinical impact of rotator cuff tears in asymptomatic volunteers.
Sonographic examinations of the shoulder of 212 asymptomatic individuals between 18 and 85 years old were performed by a single experienced operator. The prevalence and location of complete rotator cuff tears were evaluated. The clinical assessment was based on the Constant Score. Magnetic resonance imaging (MRI) of the shoulder was obtained in those patients where US showed rotator cuff pathology.
Ultrasound showed a complete rupture of the supraspinatus tendon in 6% of 212 patients from 56 to 83 years of age (mean: 67 years). MRI confirmed a complete rupture of the supraspinatus tendon in 90%. All patients reported no functional deficits, although strength was significantly lower in the patient group with complete supraspinatus tendon tear (P < 0.01).
There is a higher prevalence in older individuals of rotator cuff tendon tears that cause no pain or decrease in activities of daily living.
European Journal of Radiology 10/2004; 51(3):263-8. · 2.61 Impact Factor
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ABSTRACT: The purpose of this study was to evaluate ultrasonographic imaging as a means of easy and noninvasive diagnosis of articular and periarticular structures of the atlanto-occipital articulation in the horse; and to find a safe approach to the atlanto-occipital joint. Ultrasonographic investigations were performed on 6 healthy horses and 16 specimens from horses humanely destroyed age 2-17 years (mean 9.56 years). Preliminary examinations included anatomical studies and preparation of cross-sections. On 4 horse specimens, puncture of the atlanto-occipital joint under ultrasonographic guidance was performed and a new lateral approach undertaken. For ultrasonographic investigations, the neck was divided into 4 zones according to anatomical and clinical modalities: 1) insertion of the funiculus nuchae; 2) tuberculum dorsale of the atlas; 3) atlanto-occipital joint and 4) region above the foramen alare. Each zone was examined in transverse and longitudinal planes proceeding from cranial to caudal. Ultrasonography was found to be useful for soft tissue imaging of this region and was performed down to the atlanto-occipital joint of which the joint surfaces, joint capsule and collateral ligament could be delineated in both planes. We conclude that ultrasonography of the neck is a useful technique, representing an easy to use and safe method. However, further studies are indicated which should be performed on live subjects.
Equine Veterinary Journal 02/2002; 34(1):44-50. · 1.46 Impact Factor
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ABSTRACT: New insights in the fields of pathology and diagnostic radiology of sports injuries show that the borders between overuse syndromes and trauma are blurred. Techniques of diagnostic imaging are increasingly important for an objective documentation of morphologic changes of the musculoskeletal system. Typical sports-related syndromes exist and their clinical diagnosis is not always easy because pain cannot be located exactly.
Wiener Medizinische Wochenschrift 02/2001; 151(21-23):506-8.
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ABSTRACT: Because disability and pain may persist or recur after shoulder surgery, visualization of the postoperative shoulder before further treatment is of great interest. Postoperative status is reevaluated most frequently after rotator cuff repair, capsulorrhaphy in patients with chronic instability, and acromioplasty, where postoperative symptoms are clinically difficult to distinguish from rerupture or inadequate surgical results. Postoperative evaluation or follow-up after surgical treatment of tumors or surgical repair of shoulder injuries are other potential indications. Whereas surgical procedures for osseous components primarily will be evaluated by plain film radiographs, magnetic resonance imaging is a valuable tool for other sites of surgical treatment, such as soft-tissue components, with further potential indication for magnetic resonance arthrography. This article focuses on normal and abnormal postoperative findings in the shoulder, with emphasis of magnetic resonance imaging, and discusses specific findings based on magnetic resonance arthrography.
Topics in Magnetic Resonance Imaging 08/1999; 10(4):203-13.
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ABSTRACT: The hypothesis of a possibly diminished bony ingrowth revealed by the development of radiolucency or a radiodense line with time around a cementless femoral stem subsequent to indomethacin administration for prevention of heterotopic ossification was investigated. Eighty prospective patients with indomethacin prophylaxis were compared with 82 patients without indomethacin prophylaxis chosen retrospectively. The same cementless implant was used in all cases, and patients were observed clinically and radiologically for a minimum of 6 years. The mean postoperative Harris hip score at 6 years was 91 versus 88 points, respectively, and there were significantly more excellent results (Harris hip score > 90) in the indomethacin group. None of the patients underwent revision surgery. Radiologic signs such as loss of bone density and radiodense lines were observed around the shoulder of the prosthesis in a similar percentage in both groups. Significant subsidence of the stem was observed in one instance in the indomethacin group and in three instances in the control group. The results of this study are a strong indication that indomethacin does not influence the development of radiolucency or other radiologic changes around a cementless stem after 6 years.
Clinical Orthopaedics and Related Research 04/1999; · 2.53 Impact Factor
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ABSTRACT: Thirty-four patients were followed for a mean of 14.4 years after the Max Lange operation for instability of the shoulder. This procedure consists of an anterior capsulorraphy with lateralisation of the subscapularis tendon and the insertion of a bone block at the inferior and anterior part of the glenoid. The Rowe score showed 87% good and excellent results. External rotation and abduction were significantly limited as compared to the normal side. Radiographs revealed osteoarthrosis in 47%. Double contrast computed tomography in 18 cases showed a bony defect in the anterior and inferior part of the humeral head in 12 who had significantly limited external rotation as compared to those without the defect. Lateralisation of the subscapularis tendon with limitation of external rotation may lead to increased contact stress and shear forces at the anterior rim of the glenoid which contributes to the development of osteoarthrosis.
International Orthopaedics 02/1997; 21(4):213-6. · 2.03 Impact Factor
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ABSTRACT: The aim of the current study was to reveal whether 7 days of indomethacin treatment sufficiently prevents heterotopic ossification after cementless total hip arthroplasty. One group received indomethacin for 14 days (n = 102), and the second for 7 days (n = 99) after cementless total hip arthroplasty. At followup 1 year postoperatively, the average Harris Hip Score was 91 points in the 14-day treatment group and 89 points in the 7-day treatment group. The incidence of heterotopic ossification as outlined by Brooker was similar in both groups. Ninety-six patients in the 14-day treatment group had heterotopic ossification Grades 0 or 1, and 6 patients had Grade II heterotopic ossification; whereas in the 7-day treatment group, 95 patients had Grades 0 or 1 heterotopic ossification and 4 patients had Grade II ossification. None of the patients had Grades III or IV heterotopic ossification. In the 14-day treatment group, headache, dizziness, or gastritic disorders develop in 10 patients, and in the 7-day treatment group, 7 patients had these effects. This study shows that treatment with 100 mg indomethacin daily for 7 days is not significantly different than 14 days of treatment for the prevention of formation of severe heterotopic ossification after cementless hip arthroplasty.
Clinical Orthopaedics and Related Research 02/1997; · 2.53 Impact Factor
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ABSTRACT: In this paper the basic features of acute, subacute and chronic types of osteomyelitis, skeletal tuberculosis and some special forms of osteomyelitis are described. The diagnosis of osteomyelitis is established using clinical signs and symptoms, culture studies, laboratory studies and radiological signs. The common conservative and surgical treatments are discussed. In the treatment of posttraumatic/postoperative osteitis severe problems are encountered as a result of an increasing number of orthopaedic traumatologic surgical techniques using a variety of implants and because of a generally increasing occurrence of multiresistant strains. Thanks to modern treatment and the increased use of antibiotics, a considerable decrease in morbidity and mortality is observed. Despite this improved prognosis, an established infection remains one of the most challenging problems for the orthopaedic surgeon.
Der Radiologe 11/1996; 36(10):823-33. · 0.61 Impact Factor
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ABSTRACT: In this paper the basic features of acute, subacute and chronic types of osteomyelitis, skeletal tuberculosis and some special
forms of osteomyelitis are described. The diagnosis of osteomyelitis is established using clinical signs and symptoms, culture
studies, laboratory studies and radiological signs. The common conservative and surgical treatments are discussed. In the
treatment of post-traumatic/postoperative osteitis severe problems are encountered as a result of an increasing number of
orthopaedic traumatologic surgical techniques using a variety of implants and because of a generally increasing occurrence
of multiresistant strains. Thanks to modern treatment and the increased use of antibiotics, a considerable decrease in morbidity
and mortality is observed. Despite this improved prognosis, an established infection remains one of the most challenging problems
for the orthopaedic surgeon.
In der folgenden Arbeit werden die klinischen Bilder der akuten, subakuten und chronischen Osteomyelitis, die Knochentuberkulose
und verschiedene Sonderformen der Osteomyelitis beschrieben. Die Diagnose wird in einer Zusammenschau von klinischem Bild,
Erregernachweis und Darstellung mit bildgebenden Verfahren gestellt. Der Abschnitt Behandlung bringt einen Überblick über
die derzeit üblichen konservativen und chirurgischen Behandlungsmethoden. Aufgrund der steigenden Zahl orthopädisch-traumatologischer
Operationen unter Verwendung von verschiedensten Osteosynthesematerialien und Endoprothesen sowie aufgrund immer häufiger
auftretender multiresistenter Keime hat sich die posttraumatische/postoperative Osteitis zu einer gefürchteten Komplikation
der orthopädisch-traumatologischen Chirurgie entwickelt und an Bedeutung gewonnen. Insgesamt konnte aufgrund der modernen
Behandlungsmethoden und der verbreiteten Anwendung der Antibiotika eine deutliche Senkung der Morbidität und Mortalität erreicht
werden. Trotz der verbesserten Prognose bleibt die Osteomyelitis eine Herausforderung für den orthopädischen Chirurgen.
Der Radiologe 09/1996; 36(10):823-833. · 0.61 Impact Factor
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ABSTRACT: Patients undergoing chemotherapy for treatment of malignancy frequently experience clinically significant anemia. Myelosuppressive chemotherapy impairs erythropoiesis, which may not fully recover between treatment cycles. Recombinant human erythropoietin (rHuEPO) has been effectively introduced in anemic patients suffering from chronic renal failure. The present study was designed to assess, first, whether rHuEPO treatment decreases transfusion requirements in chemotherapy-induced anemia and, second, whether high-dose rHuEPO application is safe. STUDY DESIGN and
Thirty consecutive anemic patients (hemoglobin <11 g/dl) receiving combination chemotherapy for primary malignant bone tumors were studied in a prospective, double-blind, randomized, Phase III trial. Patients received chemotherapy according to one of two German protocols, depending on histologic diagnosis. All subjects enrolled were randomly assigned either to receive 600 IU of rHuEPO per kg of body weight intravenously twice a week or to receive a placebo during chemotherapy. To obtain comparable data, an observation period of 20 weeks was chosen. Twenty-nine patients fulfilled the criteria and were eligible for statistical evaluation.
Transfusion requirements were significantly decreased from Week 8 of therapy (p<0.05) in the treatment group. Therapeutic benefits were even more evident with continuation of therapy (Week 12, p = 0.03; Week 16, p = 0.016; Week 20, p = 0.002). The blood required was 2.1 units of red cells in the treatment group and 8.4 units of red cells in the placebo group. All patients tolerated rHuEPO with no serious side effects.
These findings suggest that rHuEPO is an effective and well-tolerated therapeutic option for decreasing the transfusion requirements in chemotherapy-induced anemia.
Transfusion 02/1996; 36(2):155-9. · 3.22 Impact Factor
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ABSTRACT: 1. Reocclusion is still a significant complication after percutaneous transluminal coronary angioplasty. The injury of coronary arteries resulting from PTCA plays an important role in the pathophysiology of both abrupt closure and late restenosis after an initially successful procedure. Cytokines play a pivotal role in the accumulation of circulating blood cells at the endothelium and are known to regulate their interaction with the vessel wall. 2. To obtain further information about this interaction, serum concentrations of soluble endothelial leukocyte adhesion molecule 1 (sELAM-1), leucocyte endothelial cell adhesion molecule 1 (sL-selectin), intercellular adhesion molecule 1 (sICAM-1), interleukin 2 receptor (sIL-2R) and interleukin 8 (IL-8) detected by enzyme-linked immunosorbent assay were monitored in 30 consecutive patients referred for elective PTCA. Fifteen patients who underwent elective coronary angiography without PTCA served as controls. 3. All patients underwent successful first PTCA. Within 24 h the serum concentrations of sELAM-1 increased gradually from 21.7 (SD 7.1) to 48.2 (SD 8.6) ng/ml (P < 0.01); levels of sL-selectin rose from 982.1 (SD 128.7) to 1541.3 (SD 104.6) ng/ml after 48 h (P < 0.01). Serum levels of IL-8 remained stable initially, but peaked at the end of the observation time of 72 h (9.4, SD 3.8, versus 16.1, SD 4.9 ng/ml; P < 0.05). A positive correlation was found between the number of dilatations and the rise in these parameters (P < 0.01). No significant changes were found in the serum concentrations of sICAM-1 and sIL-2R after PTCA or in any of the parameters in patients after coronary angiography. 4. We conclude that PTCA induces a significant rise in the concentration of certain adhesion molecules in serum. Thus, we provide preliminary data on the potential role of cytokines for blood cell-endothelium interaction after PTCA.(ABSTRACT TRUNCATED AT 250 WORDS)
Clinical Science 12/1994; 87(6):627-33. · 4.61 Impact Factor
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ABSTRACT: 1. Serum levels of erythropoietin and the immune parameters tumour necrosis factor-alpha, soluble interleukin-2 receptor, interleukin-2, interleukin-6 and interferon-gamma were measured in patients with rheumatoid arthritis. 2. Out of 69 patients, 44 had anaemia with serum haemoglobin concentrations of 10.8 (SD 1.2) g/dl. In these patients erythropoietin levels were significantly higher than in non-anaemic patients [51.97 (SD 23.9) versus 26.06 (SD 11.9) m-units/ml; P < 0.0001; control patients: 18.1 (SD 13.8) m-units/ml]. Mean soluble interleukin-2 receptor activity was elevated in all patients with rheumatoid arthritis [1324 (SD 715) units/ml; control patients: 480 (SD 75) units/ml; P < 0.001] and was significantly higher in the anaemic group than in the non-anaemic group [1562 (SD 662) versus 696 (SD 402) units/ml; P < 0.0001]. The serum activity of soluble interleukin-2 receptor showed an inverse correlation with haemoglobin (r = 0.79; P < 0.0001) and a positive correlation with erythropoietin (r = 0.70, P < 0.0001). 3. Elevated serum tumour necrosis factor-alpha levels were found in 19 anaemic patients [20.6 (SD 9.1) pg/ml]. Concentrations of tumour necrosis factor-alpha in serum showed an inverse correlation with haemoglobin (r = 0.57, P < 0.001) and a positive correlation with erythropoietin (r = 0.46, P < 0.05). Interleukin-6 was detected in seven anaemic patients [21 (SD 14) pg/ml] and interleukin-2 activity in three anaemic patients (12, 16 and 14 units/ml, respectively). Interferon-gamma was not detected in any of the patients investigated.(ABSTRACT TRUNCATED AT 250 WORDS)
Clinical Science 06/1994; 86(5):633-8. · 4.61 Impact Factor
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ABSTRACT: In a prospective series of 100 patients we investigated the effect of indomethacin for 6 weeks in the prophylaxis of ectopic bone formation in hip replacements with cementless fixation. Indomethacin prophylaxis reduced (P < 0.0001) ectopic bone formation compared to a retrospective control group of equal size. Side-effects occurred in one-fifth of the patients, but most of these could continue the medication for at least 4 weeks.
Acta Orthopaedica Scandinavica 12/1992; 63(6):628-30.
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ABSTRACT: In a study of the working group for bone tumors of the German Orthopedic Society, 33 patients with a histologically confirmed parosteal osteosarcoma at reexamination underwent clinical and radiographic follow-up. Local recurrence occurred in all the cases after intralesional surgery and in 4 of 8 cases after marginal excision. The grade of differentiation was decisive for the prognosis. Despite intralesional surgery, the prognosis for Grade 1 tumors was good. Metastases developed in 1 of 23 patients with a Grade 1 tumor and in 4 of 9 patients with a Grade 2 tumor. The single patient with a Grade 3 tumor was treated with adjuvant chemotherapy and was free of disease after 5 years.
Acta Orthopaedica Scandinavica 07/1991; 62(3):195-200.
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ABSTRACT: Reduced oxygen tension is regarded as the primary physiologic signal for the production of erythropoietin (EPO). There is little information available about early changes of EPO production in man due to severe hypoxia. The purpose of the present study was to examine the time course of EPO in serum of patients with acute cardiogenic pulmonary edema (ACPE). In 29 patients (seventy-five +/- six years, mean age +/- SEM) who were hospitalized within two hours after onset of symptoms of ACPE, serum EPO concentrations were monitored for up to seventy-two hours. At the moment of admission all patients showed significantly increased EPO concentrations of 121 +/- 64 mU/mL (mean +/- SEM) compared with a healthy population (15-35 mU/mL). Twenty-three patients who recovered within thirty minutes (group A) exhibited a quick return of their EPO serum levels to normal. The remaining 6 patients (group B) had a protracted clinical course and their EPO concentration showed a further increase up to the end of the observation period. The comparative monitoring of concentrations of alpha-1-proteinase inhibitor, antithrombin III, C-reactive protein, fibronectin, hapotoglobin, and transerrin in serum and plasma revealed no significant changes. Thus a major contribution of fluid shifts into or from the intravascular compartment to the observed changes in EPO concentration seems to be unlikely. The data suggest that the production and release of EPO in the kidneys due to altered oxygen delivery is a fast-responding mechanism.
Angiology 05/1991; 42(4):281-8. · 1.51 Impact Factor
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ABSTRACT: Between 1970 and 1987, 94 patients received 208 silicone implants at the Department of Orthopaedics, University Hospital, Vienna. Of these, 62.5% were clinically followed up. At follow-up after an average of 116 months, the implant bed was found to be intact in only 41% of cases; in all others we observed lyses around the implant and cysts even in bones at a distance from the operated joint. Histological findings obtained from revision arthroplasty showed a homogeneous picture with foreign-body granulation tissue. These changes were usually clinically inconspicuous and had little effect on patients' subjective well-being. Despite the low discomfort caused, however, the use of such implants in only recommended in critical and severe causes because of the progressive destruction of the osseous bed during the time the implant is in the body.
Archives of Orthopaedic and Trauma Surgery 02/1991; 110(3):146-50. · 1.37 Impact Factor
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La Chirurgia degli Organi di Movimento 02/1990; 75(1 Suppl):111-3.
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La Chirurgia degli Organi di Movimento 02/1990; 75(1 Suppl):191-4.
