Abstract:
BACKGROUND:The outcome of orthopaedic surgery such as total hip replacement (THR) or total knee replacement (TKR) is commonly given by the change in mean scores on patient-reported outcome measures (Prom's). This may give the impression that all enrolled patients have experienced an improvement. But the Swedish hip registry and other studies report a reduction of complaints in 80-85 % of patients ("responders"), with the remainder (approximately one in six) remaining unchanged or reporting worse complaints ("non-responders"). According to Cohen, the degree of success in the "responders" group can be subdivided into excellent, good and moderate. For a given treatment, a total of 5 different outcome groups can therefore be defined: excellent, good, moderate, unchanged and worse. Allocation to the groups is based on the "relative effect per patient" (REPP). The REPP is calculated as the base-line score minus the post-treatment score divided by the baseline score. The maximum possible REPP is 1; a REPP of 0 means no effect and a negative REPP means deterioration. Allocation to the outcome groups is as follows: excellent 0.95 to 1 REPP, good 0.5 to 0.95 REPP, moderate over 0.2 to 0.5 REPP, unchanged -0.2 to 0.2 REPP and worse below -0.2 REPP. PATIENTS AND METHODS:Our local arthroplasty register was used to evaluate the 1-year outcomes of THR and TKR patients operated between March 2003 and November 2008, using WOMAC scores and EuroQoL scores. Only patients with complete data sets and unilateral THR/TKR were included. The success rate given by the REPP method was compared with that of the "responder rate" method defined by the OMERACT-OARSI criteria. RESULTS:With the WOMAC questionnaire, outcomes were as follows (THR/TKR): excellent 29/14 %, good 51/54 %, moderate 11/13 %, unchanged at 5/12 %, worse 4/7 %. The corresponding values for the EuroQoL were (THR/TKR): excellent 16/6 %, good 41/42 %, moderate 25/28 %, unchanged 12/16 %, worse 6/8 %. For THR, success rates were 92 % using the "responder rate" method (OMERACT-OARSI criteria) and 91 % using the REPP method with the WOMAC. CONCLUSION:Calculation of the REPP and the subsequent allocation to outcome groups is simple. The distribution of outcomes depends on the intervention (THR results better than TKR) and the patient questionnaire used (better results with a condition-specific than a generic questionnaire). The proportion of "unchanged" and "moderate" outcomes was greater with the generic questionnaire than with the condition-specific questionnaire, while the proportion of "worse" outcomes was similar for the two instruments. Partitioning of the degree of success into sub-groups, based on the REPP, provides more information for both the patient and the orthopaedic surgeon.
journal_name
Z Orthop Unfalljournal_title
Zeitschrift fur Orthopadie und Unfallchirurgieauthors
Huber J,Dabis E,Zumstein MD,Hüsler Jdoi
10.1055/s-0032-1328531subject
Has Abstractpub_date
2013-06-01 00:00:00pages
239-42issue
3eissn
1864-6697issn
1864-6743journal_volume
151pub_type
杂志文章abstract::Background MRSA represents a considerable health threat to orthopaedic patients. Throughout the last decade, livestock-associated MRSA emerged increasingly in livestock all over Europe. LA-MRSA broke the species barrier, colonizing and causing infections in humans. Nevertheless, to date there are no studies concerning...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-103457
更新日期:2017-06-01 00:00:00
abstract::Surgical principles for treatment of full-thickness cartilage defects of the knee include bone marrow stimulation techniques (i.e. arthroscopic microfracturing) and transplantation techniques (i.e. autologous chondrocyte implantation and osteochondral transplantation). On the basis of increasing scientific evidence, i...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 共识发展会议,杂志文章,评审
doi:10.1055/a-0591-6457
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:In the late 1960s, the helicopter emergency medical service (HEMS) was established in Germany because of an increasing number of severe injuries in traffic accidents. To get a doctor quickly on scene was the initial intention, rather than transporting the patient. Today, rescue helicopters cover the entire f...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0035-1545801
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Currently, there is a need for scientific evidence on the efficacy of classical massage therapy for chronic, unspecific back pain, especially for the improvement in functional impairment and long-term pain reduction. According to the National Health Care Guidelines, classical massage for nonspecific low back...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,随机对照试验
doi:10.1055/a-0715-2332
更新日期:2019-06-01 00:00:00
abstract:AIM:Problems with the patellofemoral joint are still one of the most common difficulties after total knee arthroplasty. One of the main reasons for these problems seems to be the rotatory malposition of the femoral component. We examined the rotation of the femoral component and the symmetry of the flexion gap of knee ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0029-1240587
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:A new emergency room (ER) has been established in our trauma centre including an integrated CT scanner. The former ER was located at a long distance from the CT. The aim of this study was to evaluate the influence of the integrated CT in the new ER on the time period from hospital admission to CT diagnostics...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0032-1328403
更新日期:2013-04-01 00:00:00
abstract:AIMS:The combination of a distal tibia fracture with an additional upper ankle joint injury is a challenge. Apart from various implants the intraoperative problem is the handling of these two injuries with appropriate reduction and retention. The existing and further developing soft tissue damage has to be taken into c...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1039265
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Hallux valgus is one of the most prevalent foot deformities, and surgical treatment of Hallux valgus is one of the most common procedures in foot and ankle surgery. Diagnostic and treatment standards show large variation despite medical guidelines and national foot and ankle societies. The aim of this nation...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-120352
更新日期:2018-04-01 00:00:00
abstract:AIM:Dynamic gait analysis of blocked distal tibiofibular joint (TFJ) has not performed yet. This prospective study investigated patients treated for ankle fractures with combined syndesmotic complex lesions after surgery including tibiofibular positioning screw using CT data detecting fibular maltorsion and dynamic gai...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 临床试验,杂志文章
doi:10.1055/s-0029-1185695
更新日期:2009-07-01 00:00:00
abstract::Tuberculosis is one of the most common infectious diseases worldwide. The frequency in Germany is low, however, an increase has been observed in the past few years. The incidence of extrapulmonary manifestation accounts for up to 10 to 20%. In 50% of these cases the spinal column is affected. Although literature revea...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/a-1285-4994
更新日期:2021-01-21 00:00:00
abstract::The present refresher article highlights the current role of pedicled flaps in the reconstruction of complex wounds at the lower extremity. Due to the increasing standardization and ongoing improvements in microsurgery and in view of the fact that local tissue limitation and elevated rates of wound healing disorders r...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-124091
更新日期:2019-02-01 00:00:00
abstract:INTRODUCTION:The treatment of juvenile proximal humerus fractures is based on the extent of the deformity. The standard diagnosis with X-ray images in 2 directions is error-prone and can lead to a suboptimal treatment. The aim of this study was to evaluate if ultrasound imaging can improve the measurement of the deform...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1055/s-0032-1328193
更新日期:2013-02-01 00:00:00
abstract::Tibial plateau fractures are complex articular injuries, especially if caused by high energy. For adequate treatment a decidedly clinical and radiographic diagnostic is required. The three-column-concept has proven as excellent surgical planningstool in this complex trauma. By (1) precisely considering the specific ch...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0042-116779
更新日期:2017-06-01 00:00:00
abstract:AIM:The Internet provides additional and nearly endless health-related information material for the patient. On the other hand, previous studies reported on the lack of quality for health-related websites, especially for message boards. A direct analysis of treatment recommendations from message board members and spine...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0030-1250525
更新日期:2011-04-01 00:00:00
abstract:INTRODUCTION:The aim of this study was to evaluate the long term results of joint preserving surgery with hamstring release and dorsal capsulotomy for the treatment of therapy resistant knee flexion contracture in patients with severe haemophilia. METHODS:16 patients having undergone hamstring release and dorsal capsu...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 临床试验,杂志文章
doi:10.1055/s-2007-965228
更新日期:2007-05-01 00:00:00
abstract::Background: Ankle fractures are extremely common in the elderly, with an incidence of up to 39 fractures per 100,000 persons per year. We found a discrepancy between intraoperative findings and preoperative X-ray findings. It was suggested that many relevant lesions of the ankle joint in the elderly cannot be detected...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0042-113879
更新日期:2017-02-01 00:00:00
abstract:AIM:In this prospective study we have analysed the clinical outcome of complex distal radius fractures that were reduced by a dorsal approach and fixed with 2 dorsal locking plates. METHODS:In the period from January 2006 to June 2008 60 patients with a distal intra-articular instable radius fracture, who were treated...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0029-1186156
更新日期:2010-01-01 00:00:00
abstract:AIM:The aim of this study was to investigate hyaline cartilage defects treated with cell-seeded artificial matrix systems (two different collagen type I gels) with the method of optical coherence tomography (OCT) and to correlate the results with conventional histological and immunocytochemical staining. METHOD:Osteoc...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1038948
更新日期:2008-11-01 00:00:00
abstract:INTRODUCTION:Lawn mower injuries in children usually involve the lower extremities and can lead to serious amputation injuries. Treatment should look not only at the acute reconstruction, but also on maintaining the ability to grow. We report the case of a two-year-old boy with amputation of the heel. CASE REPORT:The ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0031-1298260
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:The Surgical Safety Checklist (SSC) was introduced by the World Health Organization (WHO) in 2008 in order to analyse and reduce perioperative surgical morbidity. Preoperative estimation of the expected surgery time (EST) by the surgeon is an integral part of the SSC. OBJECTIVE:The aim of the present study ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0042-101416
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Analysis of the regional development of spine surgery in Germany between 2005 and 2014. MATERIAL AND METHODS:A secondary data analysis of inpatient data from the Scientific Institute of the AOK (WIdO) was carried out for the period 2005 to 2014. The number of spinal procedures was determined on the basis of...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-124768
更新日期:2018-02-07 00:00:00
abstract:OBJECTIVE:The aim of this study was to perform a cross-cultural adaption of the KOOS into Chinese and to evaluate its psychometric properties in patients with anterior cruciate ligament reconstruction (ACL reconstruction) in mainland China. DESIGN:A cross-sectional study. SETTING:Patients completed the Chinese versio...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/a-0621-9504
更新日期:2019-02-01 00:00:00
abstract::The primary objective of osteomyelitis treatment is disinfection. Therapies can be protracted and expensive. The basic approach is to use radical debridement with antibiotics. However, radical debridement often results in major osseous defects, so it may be necessary to restore bone structures. Several different thera...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0042-100737
更新日期:2016-04-01 00:00:00
abstract:AIM:This study investigated the fusion properties of a new intervertebral spacer that is directly fixed to the adjacent vertebrae by screws. The new spacer was compared with an identical spacer without direct fixation but with an additional plate and with an autologous bone graft. METHODS:A single-level, cervical fusi...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2007-965798
更新日期:2007-11-01 00:00:00
abstract:AIM:The objective of this systematic review and meta-analysis is to obtain information about risks and associated factors for knee symptoms and the progression of osteoarthritis in idiopathic bone marrow lesion (BML). MATERIALS AND METHODS:The primary search on 31. 12. 2013 included the databases PubMed, EMBASE, Web o...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,meta分析,评审
doi:10.1055/s-0042-101560
更新日期:2016-08-01 00:00:00
abstract::Periprosthetic fractures are a challenging problem in view of the demographic development and the increasing number of implanted prostheses. Most of these fractures occur postoperatively after a period of two to four years after implantation of a total knee arthroplasty. They are usually caused by traumata, implantati...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0032-1315398
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Tibial tubercle avulsion fractures are rare, they represent less than 1% of all physeal fractures. Compared to monolateral tibial tubercle avulsion fractures, bilateral occurrence is even rarer. The purpose of this study is to report about the so far largest group of bilateral avulsion fractures and to compa...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/a-0979-2384
更新日期:2020-10-01 00:00:00
abstract::In Germany and other European countries, cancer is the second most common cause of death after cardiovascular disease. Although 5-year survival rates for several types of cancer have significantly improved over the last 30 years, metastasis to the bone almost always leads to incurable disease. Aside from the rare prim...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0043-116799
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:The use of information technology (IT) in health care has continuously increased. This includes software solutions for digitalisation, data storage and innovative approaches in diagnostics. The facilitation of the access to specific information, even by the patient, has changed daily clinical work. Patients ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-116941
更新日期:2018-02-01 00:00:00
abstract:AIM:The aim of this study was to compare the different diagnostic features (symptoms, physical examination, radiographic features and intraoperative findings) of osteoarthritis of the knee before total joint replacement and consequently relate them with each other. METHOD:Patients with primary osteoarthritis of the kn...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 临床试验,杂志文章
doi:10.1055/s-2007-965550
更新日期:2007-07-01 00:00:00