Fra onsdag 23. oktober
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
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
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
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
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
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
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
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
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)
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-
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
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
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-
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
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
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
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
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
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
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
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
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.
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
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
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
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
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
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