Posterudstilling
Fra onsdag 23. oktober
Lokale:
Christian Dippmann, Line Dahl, Finn Johansen, Michael Rindom Krogsgaard
Section for Sports Traumatology, Department of Orthopedic Surgery, Bispebjerg-Frederiksberg Hospital, Denmark; Elective Surgery Center, Silkeborg Regionshospital, Denmark; Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Bispebjerg-Frederiksberg Hospital, Denmark; Section for Sports Traumatology, Department of Orthopedic Surgery, Bispebjerg-Frederiksberg Hospital, Denmark
Background: Ultrasound guided intraarticular injection (UGII) with local anesthesia (LA) is frequently used to confirm joint related hip pain in patients with femoro- acetabular impingement syndrome (FAIS). In combination with glucocorticosteroid (GCS) it may result in long-lasting pain relief in individuals with inflammatory or degenerative joint pathologies.
Purpose / Aim of Study: The purpose of this study was to determine whether a long-lasting pain relief (> 1 day) in patients scheduled for hip arthroscopy after a positive UGII is indicative of degenerative or inflammatory changes in the hip joint.
Materials and Methods: Patients with clinical and/or radiological signs of FAIS received an UGII with LA and GCS. Immediate (within 15min) pain relief was documented at the consultation, while a long-lasting effect was registered by a follow-up mail 2 weeks later. Patients with pain relief were offered hip arthroscopy. Intraoperative findings were documented and compared to the pre-operative responds after UGII.
Findings / Results: From July 2016 to October 2018 65 patients (28 males, 37 females) underwent hip arthroscopy. Fourty-seven patients confirmed both a positive short- (< 1 day) and long-term (>2 days) effect, while 18 patients reported an isolated, temporary pain relief (< 1 day). While all patients presented intraarticular pathologies, no difference regarding inflammatory (p=0.623) changes could be seen. However, patients with grad 3 and 4 cartilage lesions were overrepresented in the group of long- lasting pain relief (p=0.049).
Conclusions: Patients with a positive UGII all had changes in the hip joint. Long lasting pain relief may indicate severe cartilage injuries.
Section for Sports Traumatology, Department of Orthopedic Surgery, Bispebjerg-Frederiksberg Hospital, Denmark; Elective Surgery Center, Silkeborg Regionshospital, Denmark; Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Bispebjerg-Frederiksberg Hospital, Denmark; Section for Sports Traumatology, Department of Orthopedic Surgery, Bispebjerg-Frederiksberg Hospital, Denmark
Background: Ultrasound guided intraarticular injection (UGII) with local anesthesia (LA) is frequently used to confirm joint related hip pain in patients with femoro- acetabular impingement syndrome (FAIS). In combination with glucocorticosteroid (GCS) it may result in long-lasting pain relief in individuals with inflammatory or degenerative joint pathologies.
Purpose / Aim of Study: The purpose of this study was to determine whether a long-lasting pain relief (> 1 day) in patients scheduled for hip arthroscopy after a positive UGII is indicative of degenerative or inflammatory changes in the hip joint.
Materials and Methods: Patients with clinical and/or radiological signs of FAIS received an UGII with LA and GCS. Immediate (within 15min) pain relief was documented at the consultation, while a long-lasting effect was registered by a follow-up mail 2 weeks later. Patients with pain relief were offered hip arthroscopy. Intraoperative findings were documented and compared to the pre-operative responds after UGII.
Findings / Results: From July 2016 to October 2018 65 patients (28 males, 37 females) underwent hip arthroscopy. Fourty-seven patients confirmed both a positive short- (< 1 day) and long-term (>2 days) effect, while 18 patients reported an isolated, temporary pain relief (< 1 day). While all patients presented intraarticular pathologies, no difference regarding inflammatory (p=0.623) changes could be seen. However, patients with grad 3 and 4 cartilage lesions were overrepresented in the group of long- lasting pain relief (p=0.049).
Conclusions: Patients with a positive UGII all had changes in the hip joint. Long lasting pain relief may indicate severe cartilage injuries.
Anne Lysgaard Schulz, Lene Dremstrup, Lone Kirkeby, Torben Bæk Hansen
University Clinic for Hand, Hip and Knee Surgery,, Regional Hospital Holstebro, Aarhus University; University Clinic for Hand, Hip and Knee Surgery,, Regional Hospital Holstebro, Aarhus University; University Clinic for Hand, Hip and Knee Surgery,, Regional Hospital Holstebro, Aarhus University; University Clinic for Hand, Hip and Knee Surgery,, Regional Hospital Holstebro, Aarhus University
Background: Total joint replacement is used for treating osteoarthritis of the trapeziometacarpal (TMC) joint. The prosthesis composes of a stem placed in the first metacarpal bone and a socket in the trapezium. It resembles the design of the total hip prothesis and may therefore have the same complications. To reduce the risk of head luxation the use of dual mobility articulation has been introduced, but in hip prosthesis dual mobility articulation has been shown to increase the wear of the polyethylene liner, and with that the risk of intraprosthetic dislocation.
Purpose / Aim of Study: To present three cases of early polywear in dual mobility TMC joint arthroplasty leading to complications and re-operation.
Materials and Methods: All three patients had a total joint replacement of the basal joint of the thumb with the Moovis (Stryker) dual mobility cementless prosthesis due to osteoarthritis of the TMC joint. The postoperative recovery period was uncomplicated, and the patients were followed with routine follow-up including radiographs at 3, 12, 24 and 60 months.
Findings / Results: After 24 months two patients presented with radiological signs of intraprosthetic luxation, and at the re-operation macroscopical signs of polywear was found leading to separation of the liner from the head. One patient presented with “clicking” of the joint and was re-operated on suspicion of collision or subluxation. At the operation macroscopical wear was found, with instability between the liner and the head. In the first case the polyethylene liner had been worn out and as a result of this the head of the prosthesis was no longer centralised in the socket. In the second case the head of the prosthesis had broken through the polyethylene liner. In the third case the polyethylene liner was worn out, so the head had extensive play in the movement in the polyethylene liner.
Conclusions: The three cases illustrate that polyethylene wear may also be a problem in small dual mobility articulations as in total joint replacement of the TMC joint. This highlights that when total joint replacement designs are transferred from one part of the body to another, the same complications may apply and should be considered.
University Clinic for Hand, Hip and Knee Surgery,, Regional Hospital Holstebro, Aarhus University; University Clinic for Hand, Hip and Knee Surgery,, Regional Hospital Holstebro, Aarhus University; University Clinic for Hand, Hip and Knee Surgery,, Regional Hospital Holstebro, Aarhus University; University Clinic for Hand, Hip and Knee Surgery,, Regional Hospital Holstebro, Aarhus University
Background: Total joint replacement is used for treating osteoarthritis of the trapeziometacarpal (TMC) joint. The prosthesis composes of a stem placed in the first metacarpal bone and a socket in the trapezium. It resembles the design of the total hip prothesis and may therefore have the same complications. To reduce the risk of head luxation the use of dual mobility articulation has been introduced, but in hip prosthesis dual mobility articulation has been shown to increase the wear of the polyethylene liner, and with that the risk of intraprosthetic dislocation.
Purpose / Aim of Study: To present three cases of early polywear in dual mobility TMC joint arthroplasty leading to complications and re-operation.
Materials and Methods: All three patients had a total joint replacement of the basal joint of the thumb with the Moovis (Stryker) dual mobility cementless prosthesis due to osteoarthritis of the TMC joint. The postoperative recovery period was uncomplicated, and the patients were followed with routine follow-up including radiographs at 3, 12, 24 and 60 months.
Findings / Results: After 24 months two patients presented with radiological signs of intraprosthetic luxation, and at the re-operation macroscopical signs of polywear was found leading to separation of the liner from the head. One patient presented with “clicking” of the joint and was re-operated on suspicion of collision or subluxation. At the operation macroscopical wear was found, with instability between the liner and the head. In the first case the polyethylene liner had been worn out and as a result of this the head of the prosthesis was no longer centralised in the socket. In the second case the head of the prosthesis had broken through the polyethylene liner. In the third case the polyethylene liner was worn out, so the head had extensive play in the movement in the polyethylene liner.
Conclusions: The three cases illustrate that polyethylene wear may also be a problem in small dual mobility articulations as in total joint replacement of the TMC joint. This highlights that when total joint replacement designs are transferred from one part of the body to another, the same complications may apply and should be considered.
Paul-Atle le fevre Roy, Anna Mi Skov
Afd M - ortopædkirurgisk, Bisbebjerg; Afd M- ortopædkirurgisk , Bisbebjerg
Background: Caput radii fractures are amongst the most common type of injuries found in adults and about 30% of elbow fractures. It usually happens when people fall from same height on a extended arm with valgus stress of the elbow. At Bisbebjerg we routinely follow up after 10-14 days including x-ray, but so far, no attempts have been made to qualify if this in fact alters the primary non operative plan.
Purpose / Aim of Study: The primary purpose of this study is to see if routine follow-ups of caput radii fractures lead to surgery.
Materials and Methods: This study is conducted as a retrospective study. A database is made from the outpatient clinic register with the last 2 years of patients who had follow-up 7-21 days after initial trauma and assigned the diagnosis of DR525 or DR525B, which is proximal radius or caput radii fractures, respectively. Fracture dislocations and fractures of both ulna and radius have a different regiment and was excluded. Fractures was reviewed and classified according to Masons and Hotchkiss classifications. The patient's history was searched up until present to see if the plans were altered from primary care, or if they later are assigned to secondary surgery due to ROM/pain issues.
Findings / Results: A total of 329 fractures was reviewed. 59 was excluded, mainly due to fracture dislocations, fractures of ulna and wrong coding, leaving 270 fractures. Of the 270 fractures 5 was assigned to primary surgery and 1 had secondary surgery with the removal of caput radii. The 5 fractures were all Mason types 2 or 3. They either involved a larger joint surface area or had large angulation or depression initially and none were assigned to surgery due to a secondary displacement. Of the 59 excluded fractures 13 had surgery.
Conclusions: Caput radii fractures are stable, and the initial care plan, operative or conservative, are rarely altered. Out of 270 fractures only 5 had ORIF, and of those none were due to a secondary displacement of the fracture. Only 1 had surgery later due to elbow ROM complications. Our results indicate that apart from patients with fracture dislocations, patients with concomitant ulna fractures and patients where there could be primary indication for surgery, there isn’t a need for follow-up.
Afd M - ortopædkirurgisk, Bisbebjerg; Afd M- ortopædkirurgisk , Bisbebjerg
Background: Caput radii fractures are amongst the most common type of injuries found in adults and about 30% of elbow fractures. It usually happens when people fall from same height on a extended arm with valgus stress of the elbow. At Bisbebjerg we routinely follow up after 10-14 days including x-ray, but so far, no attempts have been made to qualify if this in fact alters the primary non operative plan.
Purpose / Aim of Study: The primary purpose of this study is to see if routine follow-ups of caput radii fractures lead to surgery.
Materials and Methods: This study is conducted as a retrospective study. A database is made from the outpatient clinic register with the last 2 years of patients who had follow-up 7-21 days after initial trauma and assigned the diagnosis of DR525 or DR525B, which is proximal radius or caput radii fractures, respectively. Fracture dislocations and fractures of both ulna and radius have a different regiment and was excluded. Fractures was reviewed and classified according to Masons and Hotchkiss classifications. The patient's history was searched up until present to see if the plans were altered from primary care, or if they later are assigned to secondary surgery due to ROM/pain issues.
Findings / Results: A total of 329 fractures was reviewed. 59 was excluded, mainly due to fracture dislocations, fractures of ulna and wrong coding, leaving 270 fractures. Of the 270 fractures 5 was assigned to primary surgery and 1 had secondary surgery with the removal of caput radii. The 5 fractures were all Mason types 2 or 3. They either involved a larger joint surface area or had large angulation or depression initially and none were assigned to surgery due to a secondary displacement. Of the 59 excluded fractures 13 had surgery.
Conclusions: Caput radii fractures are stable, and the initial care plan, operative or conservative, are rarely altered. Out of 270 fractures only 5 had ORIF, and of those none were due to a secondary displacement of the fracture. Only 1 had surgery later due to elbow ROM complications. Our results indicate that apart from patients with fracture dislocations, patients with concomitant ulna fractures and patients where there could be primary indication for surgery, there isn’t a need for follow-up.
Simon Thorbjørn Sørensen, Rachid Bech-Azeddine, Søren Fruensgaard, Mikkel Østerheden Andersen, Leah Carreon
Center for Spine Surgery & Research, Middelfart Hospital; Center for Rheumatology and Spine Diseases, Rigshospitalet - Glostrup; Department of Orthopaedic Surgery, Regionshospitalet Silkeborg; Center for Spine Surgery & Research, Middelfart Hospital; Center for Spine Surgery & Research, Middelfart Hospital
Background: Patients with lumbar disc herniation (LDH) typically present with lower extremity radiculopathy. However, there are patients who have a concomitant substantial back pain and are considered candidates for fusion.
Purpose / Aim of Study: The purpose of this study is to determine if LDH patients with substantial back pain improve with discectomy alone.
Materials and Methods: The DaneSpine database was used to identify 2399 patients with LDH and baseline back pain Visual Analog Scale (VAS) ≥ 50 who underwent a lumbar discectomy at three facilities between June 2010 and December 2017. Standard demographic and surgical variables and patient reported outcomes including back and leg pain VAS (0-100), Oswestry Disability Index (ODI), and EuroQoL 5D (EQ-5D) at baseline and 12 months postoperatively were collected.
Findings / Results: A total of 1654 (69%) cases had 12 month data available, with a mean age of 48.7 years; 816 (49%) were male and mean BMI was 27 kg/m2. At 12 months postoperatively, there were statistically significant (p<0.000) improvements in back pain (72.6 to 36.9), leg pain (74.8 to 32.6), ODI (50.9 to 25.1) and EQ-5D (0.25 to 0.65) scores.
Conclusions: Patients with LDH and leg pain and a concomitant substantial back pain can be counseled to expect improvement in their back pain 12 months after surgery after a discectomy alone, as well as improvement in their leg pain.
Center for Spine Surgery & Research, Middelfart Hospital; Center for Rheumatology and Spine Diseases, Rigshospitalet - Glostrup; Department of Orthopaedic Surgery, Regionshospitalet Silkeborg; Center for Spine Surgery & Research, Middelfart Hospital; Center for Spine Surgery & Research, Middelfart Hospital
Background: Patients with lumbar disc herniation (LDH) typically present with lower extremity radiculopathy. However, there are patients who have a concomitant substantial back pain and are considered candidates for fusion.
Purpose / Aim of Study: The purpose of this study is to determine if LDH patients with substantial back pain improve with discectomy alone.
Materials and Methods: The DaneSpine database was used to identify 2399 patients with LDH and baseline back pain Visual Analog Scale (VAS) ≥ 50 who underwent a lumbar discectomy at three facilities between June 2010 and December 2017. Standard demographic and surgical variables and patient reported outcomes including back and leg pain VAS (0-100), Oswestry Disability Index (ODI), and EuroQoL 5D (EQ-5D) at baseline and 12 months postoperatively were collected.
Findings / Results: A total of 1654 (69%) cases had 12 month data available, with a mean age of 48.7 years; 816 (49%) were male and mean BMI was 27 kg/m2. At 12 months postoperatively, there were statistically significant (p<0.000) improvements in back pain (72.6 to 36.9), leg pain (74.8 to 32.6), ODI (50.9 to 25.1) and EQ-5D (0.25 to 0.65) scores.
Conclusions: Patients with LDH and leg pain and a concomitant substantial back pain can be counseled to expect improvement in their back pain 12 months after surgery after a discectomy alone, as well as improvement in their leg pain.
Martin Lundorff, Jeppe Lange, Juozas Petruskevicius
Department of Orthopaedics, Horsens Regional Hospital/Aarhus University Hospital; Department of Orthopaedics, Horsens Regional Hospital; Department of Orthopaedics, Aarhus University Hospital
Background: Trauma to the knee may result in fractures involving the tibial plateau (TPF). In general, intraarticular fractures increase the risk of early onset osteoarthritis (OA), due to articular depression, malalignment and joint instability. Open reduction and internal fixation (ORIF) with condylar plates is the most commonly used operation method for this type of fracture. Previous studies report main reasons for reoperation as deep infection (3,1-8,4%), compartment syndrome (14,5%), knee stiffness requiring manipulation (6%) and removal of hardware (ROH) (12,2-18%). Overall reoperation rates are seen as high as 37%.
Purpose / Aim of Study: Defining rates, causes and possible risk factors for reoperation after primary ORIF of TPF.
Materials and Methods: We have retrospectively identified 155 patients who were operated for TPF at Aarhus University Hospital, Denmark (AUH) between 2012-16. Only ORIF with unilateral or/and bicondylar plating was included. Mean age was 55 (19-87) and mean follow-up-time was 4,1 years. The most common fracture type was AO41B3 (33,6%) and all procedures were performed by senior traumatologist Types of reoperation included ROH, irrigation and debridement, compartment release, brisement forcé, amputation and arthroplasty. Statistic analysis was performed using Kaplan-Meier survival measures including baseline demographics and surgical skills. CT-scans have been assessed using AO- classification.
Findings / Results: Overall reoperation rate was found at 23,5%. ROH accounts for 19,3% vs. 4,2% for the remaining reoperation types. The infection rate was 2,6%. We have not been able to identify any tested predictor variables (gender, age, BMI, diabetes, smoking status) as influential on outcome. Final results will be presented at the DOS convention.
Conclusions: Our results are similar compared with previously published re-operation rates and causes after plating of TPF. It is mandatory to identify preoperative risk factors and select patients meticulously for this method of operation to avoid complications.
Department of Orthopaedics, Horsens Regional Hospital/Aarhus University Hospital; Department of Orthopaedics, Horsens Regional Hospital; Department of Orthopaedics, Aarhus University Hospital
Background: Trauma to the knee may result in fractures involving the tibial plateau (TPF). In general, intraarticular fractures increase the risk of early onset osteoarthritis (OA), due to articular depression, malalignment and joint instability. Open reduction and internal fixation (ORIF) with condylar plates is the most commonly used operation method for this type of fracture. Previous studies report main reasons for reoperation as deep infection (3,1-8,4%), compartment syndrome (14,5%), knee stiffness requiring manipulation (6%) and removal of hardware (ROH) (12,2-18%). Overall reoperation rates are seen as high as 37%.
Purpose / Aim of Study: Defining rates, causes and possible risk factors for reoperation after primary ORIF of TPF.
Materials and Methods: We have retrospectively identified 155 patients who were operated for TPF at Aarhus University Hospital, Denmark (AUH) between 2012-16. Only ORIF with unilateral or/and bicondylar plating was included. Mean age was 55 (19-87) and mean follow-up-time was 4,1 years. The most common fracture type was AO41B3 (33,6%) and all procedures were performed by senior traumatologist Types of reoperation included ROH, irrigation and debridement, compartment release, brisement forcé, amputation and arthroplasty. Statistic analysis was performed using Kaplan-Meier survival measures including baseline demographics and surgical skills. CT-scans have been assessed using AO- classification.
Findings / Results: Overall reoperation rate was found at 23,5%. ROH accounts for 19,3% vs. 4,2% for the remaining reoperation types. The infection rate was 2,6%. We have not been able to identify any tested predictor variables (gender, age, BMI, diabetes, smoking status) as influential on outcome. Final results will be presented at the DOS convention.
Conclusions: Our results are similar compared with previously published re-operation rates and causes after plating of TPF. It is mandatory to identify preoperative risk factors and select patients meticulously for this method of operation to avoid complications.
Ann-Mari Lawaetz, Martin Lamm, Stig Storgaard Jacobsen, Kjeld Søballe, Casper Bindzus Foldager
Department of Orthopaedics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N; Dearment of Orthopaedics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N; Department of Orthopaedics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N; Department of Orthopaedics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N; Department of Orthopaedics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N
Background: Aseptic femoral head necrosis (FHN) is a painful condition causing a progressive partial collapse of the femoral head and is usually treated with total hip arthroplasty (THA). Core decompression (CD) is a joint preserving treatment that may represent an alternative to THA as first line treatment in selected patients.
Purpose / Aim of Study: In a consecutive retrospective cohort we aim to evaluate whether CD for early stage FHN is a viable first-line treatment to improve the clinical and radiology outcomes and by that avoid THA. The primary outcome is the converting rate to THA.
Materials and Methods: Patients were included by searching the regional database (BI-Portal) by surgical code “KNFK29” core decompression of the femoral bone treated at Aarhus University Hospital from 2004 to 2019. Patients were excluded if they did not have a CD of the femoral head or were treated outside AUH. The endpoint was a THA by reviewing patients journals and cross-checking the National Hip Registry. Radiology was used to evaluate the level of the FHN before and after CD.
Findings / Results: Ten patients (12 hips) were identified (mean age 38.9 years, range: 20-65 years). Prior to year 2009 6-8mm drills were used (group 1) and after that 3.2- 3.6 mm drills were used (group 2). In group 1 THA conversion rate was 66% (2 of 3) while in group 2 conversion rate was only 14% (1 of 7) Time to THA was 14.5 months, range: 6-36 months. At three- month postoperative follow-up the patients reported minor or no groin pain. X-ray confirmed the no absence of radiological evidence of FHN.
Conclusions: CD is an easily applied, low-cost, and non-bridge burning surgical technique. In the present cohort we find encouraging results using CD with drill diameters of 3.2-3.6 mm for the treatment of FHN in selected patient with improved radiological outcome, reduction in pain and low conversion rate to THA.
Department of Orthopaedics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N; Dearment of Orthopaedics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N; Department of Orthopaedics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N; Department of Orthopaedics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N; Department of Orthopaedics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N
Background: Aseptic femoral head necrosis (FHN) is a painful condition causing a progressive partial collapse of the femoral head and is usually treated with total hip arthroplasty (THA). Core decompression (CD) is a joint preserving treatment that may represent an alternative to THA as first line treatment in selected patients.
Purpose / Aim of Study: In a consecutive retrospective cohort we aim to evaluate whether CD for early stage FHN is a viable first-line treatment to improve the clinical and radiology outcomes and by that avoid THA. The primary outcome is the converting rate to THA.
Materials and Methods: Patients were included by searching the regional database (BI-Portal) by surgical code “KNFK29” core decompression of the femoral bone treated at Aarhus University Hospital from 2004 to 2019. Patients were excluded if they did not have a CD of the femoral head or were treated outside AUH. The endpoint was a THA by reviewing patients journals and cross-checking the National Hip Registry. Radiology was used to evaluate the level of the FHN before and after CD.
Findings / Results: Ten patients (12 hips) were identified (mean age 38.9 years, range: 20-65 years). Prior to year 2009 6-8mm drills were used (group 1) and after that 3.2- 3.6 mm drills were used (group 2). In group 1 THA conversion rate was 66% (2 of 3) while in group 2 conversion rate was only 14% (1 of 7) Time to THA was 14.5 months, range: 6-36 months. At three- month postoperative follow-up the patients reported minor or no groin pain. X-ray confirmed the no absence of radiological evidence of FHN.
Conclusions: CD is an easily applied, low-cost, and non-bridge burning surgical technique. In the present cohort we find encouraging results using CD with drill diameters of 3.2-3.6 mm for the treatment of FHN in selected patient with improved radiological outcome, reduction in pain and low conversion rate to THA.
Rasmus Skov Husted, Thomas Bandholm, Michael Rathleff, Anders Troelsen, Jeanette Kirk
Clinical Research Centre, Copenhagen University Hospital Hvidovre; Clinical Research Centre, Copenhagen University Hospital Hvidovre; Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University; Clinical Orthopedic ResearcHvidovre (CORH), Department of Orthopedic Surgery, Copenhagen University Hospital Hvidovre; Clinical Research Centre, Copenhagen University Hospital Hvidovre
Background: Clinical guidelines recommend non-surgical treatment (e.g. exercise therapy) before surgery is considered in patients with end-stage knee OA. Orthopedic surgeons provide surgical care for patients eligible for surgery while patients not eligible for surgery can be referred to non- surgical treatment.
Purpose / Aim of Study: To investigate key stakeholder perspectives on enhanced coordination of non-surgical and surgical treatment in patients with end-stage knee OA.
Materials and Methods: This study is embedded within the randomized trial (the QUADX-1 trial) investigating a model of coordinated non-surgical and surgical treatment where orthopedic surgeons re-evaluate patients need for surgery following exercise therapy in the municipality (home-based exercise therapy with one exercise). Physiotherapists and orthopedic surgeons treating patients with end-stage knee OA in their clinical work were interviewed to explore their perceived facilitators and barriers related to coordinated non-surgical and surgical treatment. The interviews were analyzed using content analysis.
Findings / Results: From the content analysis three main themes emerged: 1) Physiotherapists’ ambivalence in their professional role, 2) Orthopedic surgeons view on exercise and 3) Orthopedic surgeons’ ambivalence in their professional role. Enhanced coordination of non-surgical and surgical treatment in patients with end-stage knee osteoarthritis created both facilitators and barriers among the physiotherapists and orthopedic surgeons creating ambivalence in the professional role in both professions.
Conclusions: As evidenced by the identified facilitators and barriers the intervention created ambivalence in the professional role of both the physiotherapists and orthopedic surgeons. The physiotherapists were skeptical towards too simplified exercise therapy, however, supportive of patient self- management. The orthopedic surgeons were skeptical towards the (long-term) effect of exercise therapy in patients with end-stage knee OA but acknowledge exercise therapy as a treatment option in daily clinical practice. This ambivalence in the professional role is important to consider when planning implementation of the intervention as it may appear simple but is regarded as complex.
Clinical Research Centre, Copenhagen University Hospital Hvidovre; Clinical Research Centre, Copenhagen University Hospital Hvidovre; Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University; Clinical Orthopedic ResearcHvidovre (CORH), Department of Orthopedic Surgery, Copenhagen University Hospital Hvidovre; Clinical Research Centre, Copenhagen University Hospital Hvidovre
Background: Clinical guidelines recommend non-surgical treatment (e.g. exercise therapy) before surgery is considered in patients with end-stage knee OA. Orthopedic surgeons provide surgical care for patients eligible for surgery while patients not eligible for surgery can be referred to non- surgical treatment.
Purpose / Aim of Study: To investigate key stakeholder perspectives on enhanced coordination of non-surgical and surgical treatment in patients with end-stage knee OA.
Materials and Methods: This study is embedded within the randomized trial (the QUADX-1 trial) investigating a model of coordinated non-surgical and surgical treatment where orthopedic surgeons re-evaluate patients need for surgery following exercise therapy in the municipality (home-based exercise therapy with one exercise). Physiotherapists and orthopedic surgeons treating patients with end-stage knee OA in their clinical work were interviewed to explore their perceived facilitators and barriers related to coordinated non-surgical and surgical treatment. The interviews were analyzed using content analysis.
Findings / Results: From the content analysis three main themes emerged: 1) Physiotherapists’ ambivalence in their professional role, 2) Orthopedic surgeons view on exercise and 3) Orthopedic surgeons’ ambivalence in their professional role. Enhanced coordination of non-surgical and surgical treatment in patients with end-stage knee osteoarthritis created both facilitators and barriers among the physiotherapists and orthopedic surgeons creating ambivalence in the professional role in both professions.
Conclusions: As evidenced by the identified facilitators and barriers the intervention created ambivalence in the professional role of both the physiotherapists and orthopedic surgeons. The physiotherapists were skeptical towards too simplified exercise therapy, however, supportive of patient self- management. The orthopedic surgeons were skeptical towards the (long-term) effect of exercise therapy in patients with end-stage knee OA but acknowledge exercise therapy as a treatment option in daily clinical practice. This ambivalence in the professional role is important to consider when planning implementation of the intervention as it may appear simple but is regarded as complex.
Kia Cirkeline Møller Hansen, Jensen Stefan, Viberg Bjarke
Department of Orthopaedic Surgery and Traumatology , Kolding Hospital; Department of Orthopaedic Surgery and Traumatology , Kolding Hospital; Department of Orthopaedic Surgery and Traumatology , Kolding Hospital
Background: Tension band wiring (TBW) is the most frequently used fixation for displaced olecranon fractures. TBW is in general terms known as a simple method that can be performed by most orthopaedic surgeons and has satisfying results.
Purpose / Aim of Study: The aim of this study was to determine if the quality of TBW for displaced olecranon fractures in adult patients was associated with an increase in complications.
Materials and Methods: Eligible patients were retrieved using elbow and olecranon fracture diagnosis codes from the hospital administration database. From 2013 to 2018 we found 155 patients and excluded 73 patients due to plate fixation and 21 due to other fracture diagnoses. Patient health care files were reviewed for demographics and complications defined as reoperations or loss of fixation within 6 weeks. Pre- operative x-rays were reviewed for classification and postoperative x-rays were evaluated quality of TBW based on 10 imperfections.
Findings / Results: A total of 61 patients were included, 21 males and 40 females. The median age was 64 (InterQuartileRange 26-74 and 78% were ASA≤2. There were 39 Mayo type 2A and 22 type 2B. 40 (66%) had postoperative complications. Of them were 31 (51%) minor: 7 (11%) had loss of fixation within 6 weeks (no hardware removal or reoperation) and 24 (39%) needed hardware removal after 6 months due to pain or loss of range of motion. 9 (15%) had major complications: 6 (10%) with hardware removal within 8 weeks, 1 (2%) needed reosteosynthesis, and 2 (3%) had deep infection. The quality of osteosynthesis had in the group with osteosynthesis problems (loss of fixation, reosteosynthesis, and hardware removal within 8 weeks) 0% with 0 imperfection, 50% had 1-2, 36% had 3-4, and 14% had 5 or more. The other surgeries had in comparison 9% with 0 imperfection, 53% had 1-2, 32% had 3-4, and 6% had 5 or more which lead to no association between the two groups (p=0.78).
Conclusions: In total 66% of the patients had complications and there were no association with the quality of osteosynthesis and osteosynthesis related complications. The outcome of traditional TBW is therefore questionable in the present cohort.
Department of Orthopaedic Surgery and Traumatology , Kolding Hospital; Department of Orthopaedic Surgery and Traumatology , Kolding Hospital; Department of Orthopaedic Surgery and Traumatology , Kolding Hospital
Background: Tension band wiring (TBW) is the most frequently used fixation for displaced olecranon fractures. TBW is in general terms known as a simple method that can be performed by most orthopaedic surgeons and has satisfying results.
Purpose / Aim of Study: The aim of this study was to determine if the quality of TBW for displaced olecranon fractures in adult patients was associated with an increase in complications.
Materials and Methods: Eligible patients were retrieved using elbow and olecranon fracture diagnosis codes from the hospital administration database. From 2013 to 2018 we found 155 patients and excluded 73 patients due to plate fixation and 21 due to other fracture diagnoses. Patient health care files were reviewed for demographics and complications defined as reoperations or loss of fixation within 6 weeks. Pre- operative x-rays were reviewed for classification and postoperative x-rays were evaluated quality of TBW based on 10 imperfections.
Findings / Results: A total of 61 patients were included, 21 males and 40 females. The median age was 64 (InterQuartileRange 26-74 and 78% were ASA≤2. There were 39 Mayo type 2A and 22 type 2B. 40 (66%) had postoperative complications. Of them were 31 (51%) minor: 7 (11%) had loss of fixation within 6 weeks (no hardware removal or reoperation) and 24 (39%) needed hardware removal after 6 months due to pain or loss of range of motion. 9 (15%) had major complications: 6 (10%) with hardware removal within 8 weeks, 1 (2%) needed reosteosynthesis, and 2 (3%) had deep infection. The quality of osteosynthesis had in the group with osteosynthesis problems (loss of fixation, reosteosynthesis, and hardware removal within 8 weeks) 0% with 0 imperfection, 50% had 1-2, 36% had 3-4, and 14% had 5 or more. The other surgeries had in comparison 9% with 0 imperfection, 53% had 1-2, 32% had 3-4, and 6% had 5 or more which lead to no association between the two groups (p=0.78).
Conclusions: In total 66% of the patients had complications and there were no association with the quality of osteosynthesis and osteosynthesis related complications. The outcome of traditional TBW is therefore questionable in the present cohort.
Troels Kjeldsen, Inger Mechlenburg, Susan Merrild Drejer, Lisa Reimer, Lars Grøndahl Hvid, Ulrik Dalgas
Department of sport science, Aarhus University; Department of orthopaedic surgery, Aarhus University Hospital; Department of orthopaedic physical therapy, Silkeborg Hospital; Department of orthopaedic surgery, Aarhus University Hospital; Department of sport science, Aarhus University; Department of sport science, Aarhus University
Background: Little is known about the feasibility of progressive resistance training (PRT) applied to patients with symptomatic external snapping hip (SESH). In related hip disorders, PRT has proven to be feasible with high training adherence.
Purpose / Aim of Study: The primary purpose was to investigate whether PRT is feasible in patients with SESH and secondary, to explore potential effects of PRT on hip pain, hip-related function, awareness of the hip joint and muscle strength.
Materials and Methods: Nine patients with SESH were recruited for a 12-week supervised PRT intervention. Feasibility was measured by drop-out rate, adverse events, pain exacerbation (VAS) and adherence to the PRT. At baseline and at end of treatment patients completed the Copenhagen Hip and Groin Outcome Score (HAGOS), the Forgotten Joint Score (FJS), maximal voluntary contraction strength (MVC) for isometric, concentric and eccentric hip abduction and extension, one-repetition-maximum strength (1RM), and a loaded stair test (LST).
Findings / Results: Three patients (33%) dropped out during the PRT intervention. Few and minor adverse events were observed. Pain scores were acceptable (VAS < 50 mm) in 76% of all training sessions and a significant overall decrease in pain during PRT was found (-10.5 mm, 95% CI [-17.7 to -3.2]). Training adherence was 96.7 ± 4.2%. Per protocol analyses showed statistically significant and clinically relevant improvements (p 0.05) in all HAGOS subscales (ranging from 27.5 to 41.7 points), FJS (+31.6 points), MVC strength for the most affected hip in concentric (+12.8%) hip abduction and isometric (+27.2%), concentric (+21.5%) and eccentric (+12.4%) hip extension, 1RM strength in leg press (+53.5%) and hip abduction for the most affected hip (+100.2%) and the least affected hip (+66.7%), and time to complete the LST (-25.4%).
Conclusions: PRT seems feasible in patients with SESH. Furthermore, the present study suggests that PRT may improve hip pain, function, awareness and muscle strength in these patients.
Department of sport science, Aarhus University; Department of orthopaedic surgery, Aarhus University Hospital; Department of orthopaedic physical therapy, Silkeborg Hospital; Department of orthopaedic surgery, Aarhus University Hospital; Department of sport science, Aarhus University; Department of sport science, Aarhus University
Background: Little is known about the feasibility of progressive resistance training (PRT) applied to patients with symptomatic external snapping hip (SESH). In related hip disorders, PRT has proven to be feasible with high training adherence.
Purpose / Aim of Study: The primary purpose was to investigate whether PRT is feasible in patients with SESH and secondary, to explore potential effects of PRT on hip pain, hip-related function, awareness of the hip joint and muscle strength.
Materials and Methods: Nine patients with SESH were recruited for a 12-week supervised PRT intervention. Feasibility was measured by drop-out rate, adverse events, pain exacerbation (VAS) and adherence to the PRT. At baseline and at end of treatment patients completed the Copenhagen Hip and Groin Outcome Score (HAGOS), the Forgotten Joint Score (FJS), maximal voluntary contraction strength (MVC) for isometric, concentric and eccentric hip abduction and extension, one-repetition-maximum strength (1RM), and a loaded stair test (LST).
Findings / Results: Three patients (33%) dropped out during the PRT intervention. Few and minor adverse events were observed. Pain scores were acceptable (VAS < 50 mm) in 76% of all training sessions and a significant overall decrease in pain during PRT was found (-10.5 mm, 95% CI [-17.7 to -3.2]). Training adherence was 96.7 ± 4.2%. Per protocol analyses showed statistically significant and clinically relevant improvements (p 0.05) in all HAGOS subscales (ranging from 27.5 to 41.7 points), FJS (+31.6 points), MVC strength for the most affected hip in concentric (+12.8%) hip abduction and isometric (+27.2%), concentric (+21.5%) and eccentric (+12.4%) hip extension, 1RM strength in leg press (+53.5%) and hip abduction for the most affected hip (+100.2%) and the least affected hip (+66.7%), and time to complete the LST (-25.4%).
Conclusions: PRT seems feasible in patients with SESH. Furthermore, the present study suggests that PRT may improve hip pain, function, awareness and muscle strength in these patients.
Anders Kjørup, Klaus Bak
Clinic of Handsurgery, Gentofte Hospital; Orthopaedic Department, Kysthospitalet
Background: Thoracic outlet syndrome is a compression of the vessels and nerves to the upper limb. The most distale site of compression is the plexus brachialis under the pectoralis minor (PM) tendon. This can cause local pain and distal nerve affection of a second compression site in a “double crush” picture.
Purpose / Aim of Study: -
Materials and Methods: -
Findings / Results: 23 y/o girl with a history of 10 years handball, playing as goalkeeper presenting with carpal tunnel syndrome. She is twice decompressed on the clinical picture but has recurrence of symptoms. Neurophysiology is negative. On contact she presents with pain of the shoulder, scapula dyskinesia and fatigue of the hand on daily use. No nightly dysaesthesia. Continuous decreased sensibility of the median and radial nerve, together with decreased strength of high and low innervated muscles of same nerves. Positive Tinels of median nerve to infraclavicular level. Chest x-ray shows no cervical costa. MRI, EMG and nerve ultrasonography normal. On suspicion of pectoralis minor syndrome physiotherapy is initiated, worsening symptoms and following there is done ultrasonic guide botox injections in the thickest part of the PM. After 2 weeks relieve of symptoms but recurrence after 2 months. Another injection is made but again recurrence after 2 months. Surgery with a deltopectoral approach, a PM tenotomy from processus coracoideus with shortning of the tendon, is done. Physiotherapy with PM exercises shows gradual recovery. The patient is seen 6 months postoperative with full recovery of shoulder function without pain or fatigue. Distal normal sensibility.
Conclusions: Pectoralis minor syndrome (PMS) can present in a neurogenic disguise and can be difficult to classify. Rarely there will be a positive paraclinic picture. The patient history is often containing a trauma or sports with repetitive shoulder stress activity (handball, swimming and volleyball). Clinically there will be pain of the PM tendon and positive Tinels, “Upper Limb Tension Test” and “Elevated Arm Stress Test”. A pectoralis minor muscle bloc can be used as a diagnostic tool. Neurophysiologically examination of the medial antebrachial cutaneous nerve shows good results. Surgery has a high success rate with no recurrence.
Clinic of Handsurgery, Gentofte Hospital; Orthopaedic Department, Kysthospitalet
Background: Thoracic outlet syndrome is a compression of the vessels and nerves to the upper limb. The most distale site of compression is the plexus brachialis under the pectoralis minor (PM) tendon. This can cause local pain and distal nerve affection of a second compression site in a “double crush” picture.
Purpose / Aim of Study: -
Materials and Methods: -
Findings / Results: 23 y/o girl with a history of 10 years handball, playing as goalkeeper presenting with carpal tunnel syndrome. She is twice decompressed on the clinical picture but has recurrence of symptoms. Neurophysiology is negative. On contact she presents with pain of the shoulder, scapula dyskinesia and fatigue of the hand on daily use. No nightly dysaesthesia. Continuous decreased sensibility of the median and radial nerve, together with decreased strength of high and low innervated muscles of same nerves. Positive Tinels of median nerve to infraclavicular level. Chest x-ray shows no cervical costa. MRI, EMG and nerve ultrasonography normal. On suspicion of pectoralis minor syndrome physiotherapy is initiated, worsening symptoms and following there is done ultrasonic guide botox injections in the thickest part of the PM. After 2 weeks relieve of symptoms but recurrence after 2 months. Another injection is made but again recurrence after 2 months. Surgery with a deltopectoral approach, a PM tenotomy from processus coracoideus with shortning of the tendon, is done. Physiotherapy with PM exercises shows gradual recovery. The patient is seen 6 months postoperative with full recovery of shoulder function without pain or fatigue. Distal normal sensibility.
Conclusions: Pectoralis minor syndrome (PMS) can present in a neurogenic disguise and can be difficult to classify. Rarely there will be a positive paraclinic picture. The patient history is often containing a trauma or sports with repetitive shoulder stress activity (handball, swimming and volleyball). Clinically there will be pain of the PM tendon and positive Tinels, “Upper Limb Tension Test” and “Elevated Arm Stress Test”. A pectoralis minor muscle bloc can be used as a diagnostic tool. Neurophysiologically examination of the medial antebrachial cutaneous nerve shows good results. Surgery has a high success rate with no recurrence.
Lisa Cecilie Urup Reimer, Julie Sandell Jacobsen, Inger Mechlenburg
Orthopaedics, Aarhus University Hospital; Physiotherapy, Faculty of Health Sciences, VIA University College, Aarhus; Clinical Medicine, Aarhus University
Background: Greater trochanteric pain syndrome (GTPS) is a common and disabling hip condition. Hypermobility has been suggested as a possible cause of GTPS.
Purpose / Aim of Study: The purpose of this study was to report the prevalence of hypermobility and to investigate its impact on hip-related function and awareness in patients with GTPS.
Materials and Methods: This cross-sectional study was based on a cohort of patients diagnosed with GTPS in the 2013-2015 period. Hypermobility was investigated with the Beighton Score and defined by a cut-off score ≥ 5. Data on patients‘ current hip function and awareness were collected with the questionnaires the Copenhagen Hip and Groin Outcome Score and the Forgotten Joint Score.
Findings / Results: A total of 612 patients with GTPS were identified based on the diagnosis system; out of those, 390 patients were assessed for eligibility, and 145 (37%) were included. The prevalence of hypermobility within this cohort was estimated to be 11% (95% confidence interval (CI): 3-26%) for males and 25% (95% CI: 17-34%) for females. No significant association was found between hypermobility and self- reported hip function and awareness.
Conclusions: The prevalence of hypermobility in patients with GTPS was high, but the prevalence of hypermobility did not influence hip function and awareness. The results were based on a very low response rate and should be interpreted with this in mind.
Orthopaedics, Aarhus University Hospital; Physiotherapy, Faculty of Health Sciences, VIA University College, Aarhus; Clinical Medicine, Aarhus University
Background: Greater trochanteric pain syndrome (GTPS) is a common and disabling hip condition. Hypermobility has been suggested as a possible cause of GTPS.
Purpose / Aim of Study: The purpose of this study was to report the prevalence of hypermobility and to investigate its impact on hip-related function and awareness in patients with GTPS.
Materials and Methods: This cross-sectional study was based on a cohort of patients diagnosed with GTPS in the 2013-2015 period. Hypermobility was investigated with the Beighton Score and defined by a cut-off score ≥ 5. Data on patients‘ current hip function and awareness were collected with the questionnaires the Copenhagen Hip and Groin Outcome Score and the Forgotten Joint Score.
Findings / Results: A total of 612 patients with GTPS were identified based on the diagnosis system; out of those, 390 patients were assessed for eligibility, and 145 (37%) were included. The prevalence of hypermobility within this cohort was estimated to be 11% (95% confidence interval (CI): 3-26%) for males and 25% (95% CI: 17-34%) for females. No significant association was found between hypermobility and self- reported hip function and awareness.
Conclusions: The prevalence of hypermobility in patients with GTPS was high, but the prevalence of hypermobility did not influence hip function and awareness. The results were based on a very low response rate and should be interpreted with this in mind.
Torsten Warming, Peter Lavard, Martin Rathcke, Christian Dippmann, Lars Konradsen, Anke Simone Rechter, Michael Rindom Krogsgaard
Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hspital; Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hospital; Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hospital; Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hospital; Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hospital; Section for Sports Traumatology M51, Bspebjerg and Frederiksberg Hospital; Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hospital
Background: It is documented in literature, that reinsertion of proximal avulsions of semitendinosus, semimembranosus and biceps femoris from the ischial tuberosity in younger patients, including athletes, result in good patient satisfaction and a high rate of return-to-sports. However, in a recent meta-analysis the complication rate was reported as 23 % There is very sparse evidence in literature in relation to treatment of middle-aged patients and patients who are past the acute phase. Middle-aged patients treated non-surgically have substantial strength deficits, but there is no difference in Lower Extremity Functional Score between series of surgically and non-surgically treated patients.
Purpose / Aim of Study: The aim of this study was to report the results of reinsertion or reconstruction of the proximal hamstrings in patients older than 35 years.
Materials and Methods: Consecutive patients operated since 2011 were included. Complications were recorded and patient satisfaction was registered at follow-up.
Findings / Results: Sixteen patients, mean age 52.4 year (range: (36-69) (8 women and 8 men) were operated. In 11 cases all three tendons (semitendinosus, semimembranosus and biceps femoris) had been avulsed and in 5 cases only two tendons. The mean interval between the injury and operation was 112 days (range 7-700). In 15 patients it was possible to reinsert the tendons directly onto the ischial tuberosity, and in one case it was necessary to reconstruct the tendons with allograft tendon material. There were no postoperative symptoms (temporary or permanent) from the sciatic nerve and no deep infections. At follow-up all patients were satisfied with the result.
Conclusions: Reattachment of proximal hamstrings avulsions show good results in middle- aged patients, and can be performed after the acute phase with positive result.
Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hspital; Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hospital; Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hospital; Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hospital; Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hospital; Section for Sports Traumatology M51, Bspebjerg and Frederiksberg Hospital; Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hospital
Background: It is documented in literature, that reinsertion of proximal avulsions of semitendinosus, semimembranosus and biceps femoris from the ischial tuberosity in younger patients, including athletes, result in good patient satisfaction and a high rate of return-to-sports. However, in a recent meta-analysis the complication rate was reported as 23 % There is very sparse evidence in literature in relation to treatment of middle-aged patients and patients who are past the acute phase. Middle-aged patients treated non-surgically have substantial strength deficits, but there is no difference in Lower Extremity Functional Score between series of surgically and non-surgically treated patients.
Purpose / Aim of Study: The aim of this study was to report the results of reinsertion or reconstruction of the proximal hamstrings in patients older than 35 years.
Materials and Methods: Consecutive patients operated since 2011 were included. Complications were recorded and patient satisfaction was registered at follow-up.
Findings / Results: Sixteen patients, mean age 52.4 year (range: (36-69) (8 women and 8 men) were operated. In 11 cases all three tendons (semitendinosus, semimembranosus and biceps femoris) had been avulsed and in 5 cases only two tendons. The mean interval between the injury and operation was 112 days (range 7-700). In 15 patients it was possible to reinsert the tendons directly onto the ischial tuberosity, and in one case it was necessary to reconstruct the tendons with allograft tendon material. There were no postoperative symptoms (temporary or permanent) from the sciatic nerve and no deep infections. At follow-up all patients were satisfied with the result.
Conclusions: Reattachment of proximal hamstrings avulsions show good results in middle- aged patients, and can be performed after the acute phase with positive result.
Balint Vajta, Jeppe Lange, Bent Lund
Center for Planlagt Kirurgi, Hospitalsenheden Midt; Ortopædkirurgisk Afdeling, Regionshospitalet Horsens; Ortopædkirurgisk Afdeling, Regionshospitalet Horsens
Background: The surgical approach for treatment of proximal hamstring avulsions is increasing in prevalence in Denmark as the advancement in operative techniques yield better results. There is therefore a need for a tool in Danish, which assesses the patient’s clinical condition pre- and postoperatively by utilizing patient reported outcomes.
Purpose / Aim of Study: The purpose of this study was to translate, test and validate the Perth Hamstring Assessment Tool (PHAT), an existing English self-reported questionnaire, for future utilization in a clinical setting.
Materials and Methods: Translation of the PHAT questionnaire was done following standardized translation protocol. Patients treated for hamstring injuries from 2010 to 2018 at RH Horsens were identified using the Danish electronic patient chart system.13 participants completed the questionnaire at baseline and at the 1-2 month follow-up via telephone. Data analysis was performed to test the internal consistency and reproducibility of the translated PHAT questionnaire.
Findings / Results: All 13 participants fully completed the questionnaire. Data analysis revealed a Cronbach's alpha of 0.87 at baseline and 0.85 at follow up, and a cumulative intra-class correlation coefficient of 0.677 from baseline to follow-up.
Conclusions: The study succeeded in the translation of the PHAT-score from English to Danish, supported by a high completion rate and high internal consistency. The limited number of included participants warranted for a more direct verbal contact to ensure the highest number of respondents. The approach may have had an effect on the statistical differences in reproducibility. A larger scale evaluation of the PHAT-score is required to further validate the Danish translation before the questionnaire can safely be utilized in a clinical setting for evaluation of patients with proximal hamstring avulsions. Due to the limited number of patients available at individual centers, the authors plan to initiate a multi-center study to achieve this task.
Center for Planlagt Kirurgi, Hospitalsenheden Midt; Ortopædkirurgisk Afdeling, Regionshospitalet Horsens; Ortopædkirurgisk Afdeling, Regionshospitalet Horsens
Background: The surgical approach for treatment of proximal hamstring avulsions is increasing in prevalence in Denmark as the advancement in operative techniques yield better results. There is therefore a need for a tool in Danish, which assesses the patient’s clinical condition pre- and postoperatively by utilizing patient reported outcomes.
Purpose / Aim of Study: The purpose of this study was to translate, test and validate the Perth Hamstring Assessment Tool (PHAT), an existing English self-reported questionnaire, for future utilization in a clinical setting.
Materials and Methods: Translation of the PHAT questionnaire was done following standardized translation protocol. Patients treated for hamstring injuries from 2010 to 2018 at RH Horsens were identified using the Danish electronic patient chart system.13 participants completed the questionnaire at baseline and at the 1-2 month follow-up via telephone. Data analysis was performed to test the internal consistency and reproducibility of the translated PHAT questionnaire.
Findings / Results: All 13 participants fully completed the questionnaire. Data analysis revealed a Cronbach's alpha of 0.87 at baseline and 0.85 at follow up, and a cumulative intra-class correlation coefficient of 0.677 from baseline to follow-up.
Conclusions: The study succeeded in the translation of the PHAT-score from English to Danish, supported by a high completion rate and high internal consistency. The limited number of included participants warranted for a more direct verbal contact to ensure the highest number of respondents. The approach may have had an effect on the statistical differences in reproducibility. A larger scale evaluation of the PHAT-score is required to further validate the Danish translation before the questionnaire can safely be utilized in a clinical setting for evaluation of patients with proximal hamstring avulsions. Due to the limited number of patients available at individual centers, the authors plan to initiate a multi-center study to achieve this task.