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Ostojic M, Hakam HT, Lovrekovic B, Ramadanov N, Prill R. Treatment of anterior knee pain due to chondromalacia patellae with platelet-rich plasma and hyaluronic acid in young and middle-aged adults, a cohort study. Arch Orthop Trauma Surg 2024:10.1007/s00402-024-05363-w. [PMID: 38780774 DOI: 10.1007/s00402-024-05363-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 05/05/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Anterior knee pain commonly affects young women resulting in the declination of the quality of life. One of the possible pathologies causing this symptom is chondromalacia patellae (CMP). Although CMP is used to describe the softening of patellar articular cartilage, it remains a general descriptive term as it cannot be associated with a specific pathophysiologic mechanism. The objective of this study is to investigate the effect of injectable PRP on patients with anterior knee pain in absence of altered patellofemoral joint anatomy. METHODS For this purpose, 43 patients of the affected population were recruited to participate in this non-randomized controlled trial, 28 patients in the injection group and 15 in the only-physiotherapy group. While patients in the experimental group received three PRP injections and one injection of hyaluronic acid (HA), comparators received the standard physical therapy regimen. The treatment choice was based on patients own decree. Patients between the ages of 18 to 50 years with anterior knee pain and positive Clarke´s sign were eligible for inclusion. Patients with evident anatomical abnormalities, chronic conditions affecting the knee and severe symptoms such as blocking, were excluded from the study. Patient related measures (PROMS) in the form of the VAS and the Kujala scores were the main outcome of interest. All outcomes were measured at baseline, and after 3 and 6 months after the treatment. RESULTS Although an improvement was seen in both groups, a statistically significant difference favoring the injection of PRP over the physiotherapy-only group was observed (p < 0.001). The superiority of the therapeutic modality under investigation was observed at 3 and 6 months after the initial diagnosis was made. Furthermore, the results of this study revealed a significant improvement at 3 and 6 months when compared to baseline measures. The analysis of the patients age showed a negative correlation when baseline values were compared to measures at 3 and 6 months, meaning younger patients had more benefit from the treatment. DISCUSSION The main results of this study affirm the positive effects of PRP and HA for the treatment of anterior knee pain described by previous research and the subsequent improvement of the quality of life. Relatively little information was found in the literature search regarding the therapeutic effects of PRP on anterior knee pain and chondropathies. While a previous radiologic study found no evidence regarding the effect of PRP, this study found a benefit when comparing PROMs between patient groups.
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Affiliation(s)
- Marko Ostojic
- Department of Orthopaedics and Traumatology, University Hospital Mostar, Bijeli brijeg bb, Mostar, 88000, Bosnia and Herzegovina.
- Osteon Orthopedics and Sports Medicine Clinic, Mostar, Bosnia and Herzegovina.
| | - Hassan Tarek Hakam
- Center of Orthopaedics and Traumatology, Brandenburg Medical School, University Hospital Brandenburg/Havel, Brandenburg an der Havel, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - Bruno Lovrekovic
- Department of Orthopaedics, University hospital Merkur, Zagreb, Croatia
| | - Nikolai Ramadanov
- Center of Orthopaedics and Traumatology, Brandenburg Medical School, University Hospital Brandenburg/Havel, Brandenburg an der Havel, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, Brandenburg Medical School, University Hospital Brandenburg/Havel, Brandenburg an der Havel, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
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Prill R, Hakam H, Karlsson J, Ramadanov N, Alfuth M, Królikowska A. Structured success: Study protocols and preregistration in orthopaedics, sports medicine and rehabilitation. Knee Surg Sports Traumatol Arthrosc 2024; 32:1065-1070. [PMID: 38488255 DOI: 10.1002/ksa.12126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 04/23/2024]
Affiliation(s)
- Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
| | - Hassan Hakam
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
| | - Jon Karlsson
- Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nikolai Ramadanov
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
| | - Martin Alfuth
- Faculty of Health Care, Therapeutic Sciences, Niederrhein University of Applied Sciences, Krefeld, Germany
| | - Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Wroclaw Medical University, Wroclaw, Poland
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Ramadanov N, Voss M, Hable R, Prill R, Hakam HT, Salzmann M, Dimitrov D, Becker R. Patient-related Predictors for the Functional Outcome of SuperPATH Hemiarthroplasty versus Conventional Approach Hemiarthroplasty: A Systematic Review and Meta-regression Analysis of Randomized Controlled Trials. Orthop Surg 2024; 16:791-801. [PMID: 38298174 PMCID: PMC10984811 DOI: 10.1111/os.14006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/09/2024] [Accepted: 01/09/2024] [Indexed: 02/02/2024] Open
Abstract
Specialist literature lacks evidence that explores associations between patient characteristics and the beneficial treatment effect of SuperPATH hemiarthroplasty (HA) compared with conventional approach (CA) HA. To investigate and identify patient-related predictors of the effect size of the short-term functional outcome of SuperPATH HA and CA HA by performing a systematic review and meta-regression analysis of randomized controlled trials (RCTs). A systematic search of literature was performed in PubMed, CNKI, CENTRAL of The Cochrane Library, Clinical trials, and Google Scholar until August 25, 2023. For the continuous outcome parameter Harris hip score (HHS) ≤1 week and 3 months postoperatively, mean differences (MDs) with 95% confidence intervals (CIs) were calculated. A meta-regression analysis was based on random-effects meta-analysis using the Hartung-Knapp-Sidik-Jonkman method for continuous covariates. A total of five RCTs with 404 patients were found. The following predictors of HHS ≤1 week postoperatively were identified: patient age (predictor estimate = 1.29; p < 0.01), patient age groups (predictor estimate = 14.07; p < 0.01), time to mobilization (predictor estimate = 5.51; p < 0.01). The following predictors of HHS 3 months postoperatively were identified: incision length (predictor estimate = -2.12; p < 0.01); intraoperative blood loss (predictor estimate = 0.02; p < 0.01). Patient age, time to mobilization, incision length, and intraoperative blood loss were identified as predictors of the effect size of early postoperative functional outcome as measured by HHS. Elderly patients, particularly those over 70 years of age, appear to benefit from SuperPATH HA. Based on these findings, and taking into account our limitations, we recommend that the use of minimally invasive SuperPATH HA in elderly patients should be more widely considered and not limited to elective THA patients.
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Affiliation(s)
- Nikolai Ramadanov
- Center of Orthopedics and TraumatologyUniversity Hospital Brandenburg an der Havel, Brandenburg Medical School Theodor FontaneBrandenburg an der HavelGermany
- Faculty of Health Science BrandenburgBrandenburg Medical School Theodor FontaneBrandenburg an der HavelGermany
| | - Maximilian Voss
- Center of Orthopedics and TraumatologyUniversity Hospital Brandenburg an der Havel, Brandenburg Medical School Theodor FontaneBrandenburg an der HavelGermany
| | - Robert Hable
- Faculty of Applied Computer ScienceDeggendorf Institute of TechnologyDeggendorfGermany
| | - Robert Prill
- Center of Orthopedics and TraumatologyUniversity Hospital Brandenburg an der Havel, Brandenburg Medical School Theodor FontaneBrandenburg an der HavelGermany
- Faculty of Health Science BrandenburgBrandenburg Medical School Theodor FontaneBrandenburg an der HavelGermany
| | - Hassan Tarek Hakam
- Center of Orthopedics and TraumatologyUniversity Hospital Brandenburg an der Havel, Brandenburg Medical School Theodor FontaneBrandenburg an der HavelGermany
- Faculty of Health Science BrandenburgBrandenburg Medical School Theodor FontaneBrandenburg an der HavelGermany
| | - Mikhail Salzmann
- Center of Orthopedics and TraumatologyUniversity Hospital Brandenburg an der Havel, Brandenburg Medical School Theodor FontaneBrandenburg an der HavelGermany
- Faculty of Health Science BrandenburgBrandenburg Medical School Theodor FontaneBrandenburg an der HavelGermany
| | - Dobromir Dimitrov
- Department of Surgical Propedeutics, Faculty of MedicineMedical University of PlevenPlevenBulgaria
| | - Roland Becker
- Center of Orthopedics and TraumatologyUniversity Hospital Brandenburg an der Havel, Brandenburg Medical School Theodor FontaneBrandenburg an der HavelGermany
- Faculty of Health Science BrandenburgBrandenburg Medical School Theodor FontaneBrandenburg an der HavelGermany
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Wiecha S, Posadzki P, Prill R, Płaszewski M. Physical Therapies for Delayed Onset Muscle Soreness: A Protocol for an Umbrella and Mapping Systematic Review with Meta-Meta-Analysis. J Clin Med 2024; 13:2006. [PMID: 38610771 PMCID: PMC11012564 DOI: 10.3390/jcm13072006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/15/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Delayed onset muscle soreness (DOMS), also known as exercise-induced muscle damage (EIMD), is typically caused by strenuous and/or unaccustomed physical exercise. DOMS/EIMD manifests itself in reduced muscle strength and performance levels, increased muscle soreness, swelling, and elevated levels of inflammatory biomarkers. Numerous randomised controlled trials (RCTs) and systematic reviews (SRs) of a wide variety of physiotherapy interventions for reducing the signs and symptoms of DOMS/EIMD have been published. However, these SRs often arrive at contradictory conclusions, impeding decision-making processes. OBJECTIVE We will systematically review the current evidence on clinical outcomes (efficacy, safety) of physiotherapy interventions for the treatment of DOMS/EIMD in healthy adults. We will also assess the quality of the evidence and identify, map, and summarise data from the available SRs. METHOD Umbrella review with evidence map and meta-meta-analyses. MEDLINE, Embase, Cochrane Database of Systematic Reviews, Epistemonikos and PEDro will be searched from January 1998 until February 2024. SRs of RCTs of any treatment used by physiotherapists (e.g., low-level laser therapy, electrical stimulation, heat/cold therapy, ultrasound, magnets, massage, manual therapies) to treat DOMS/EIMD in healthy adults will be eligible. Narrative/non-systematic reviews, studies of adolescents/children and medically compromised individuals, of complementary therapies, dietary, nutritional, or pharmacological interventions, as well as self-administered interventions, or those published before 1998, will be excluded. AMSTAR 2 will be used to evaluate the methodological quality of the included SRs. Corrected covered area, will be computed for assessing overlaps among included SRs, and an evidence map will be prepared to describe the credibility of evidence for interventions analysed in the relevant SRs. DISCUSSION DOMS/EIMD is a complex condition, and there is no consensus regarding the standard of clinical/physiotherapeutic care. By critically evaluating the existing evidence, we aim to inform clinicians about the most promising therapies for DOMS/EIMD. This umbrella review has the potential to identify gaps in the existing evidence base that would inform future research. The protocol has been registered at PROSPERO (CRD42024485501].
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Affiliation(s)
- Szczepan Wiecha
- Department of Physical Education and Health in Biala Podlaska, Faculty in Biala Podlaska, Jozef Pilsudski University of Physical Education, 00-968 Warsaw, Poland
| | - Paweł Posadzki
- Department of Clinical Rehabilitation, University School of Physical Education in Kraków, 31-571 Kraków, Poland
- Kleijnen Systematic Reviews Ltd., York YO19 6FD, UK
| | - Robert Prill
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg a.d.H., Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
| | - Maciej Płaszewski
- Department of Physical Education and Health in Biala Podlaska, Faculty in Biala Podlaska, Jozef Pilsudski University of Physical Education, 00-968 Warsaw, Poland
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Diquattro E, Prill R, Salzmann M, Traina F, Becker R. High three-dimensional accuracy of component placement and lower limb alignment using a robotic arm-assisted system and gap-balancing instrument in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2024; 32:685-692. [PMID: 38415872 DOI: 10.1002/ksa.12088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE It was hypothesized that robotic arm-assisted total knee arthroplasty (RA-TKA) using additionally a gap-balancing instrumentation will show high accuracy in executing the planning in femoral and tibial component placement throughout the range of knee motion (ROM) during TKA surgery. METHODS Prospectively collected data were analysed for patients undergoing RA-TKA. A cruciate retaining cemented design was implanted using the MAKO® robotic system. Lower limb alignment at 0°, 30°, 45°, 60° and 90° of flexion was recorded at the beginning of surgery and finally after implantation of the components. A ligament tensioner was inserted after tibial precut to measure the extension and flexion gap, and final component placement was planned based on 3D CT images. Femoral and tibial component placement was measured in all three planes. RESULTS A total of 104 patients were included (mean age 69.4 ± 9 years; 44 male, 60 female). The difference in component placement after planning and final implantation showed less valgus of 0.7° ± 1.4° (p < 0.001), less external rotation of 0.6° ± 1.9° (p = 0.001) and less flexion of 0.9° ± 1.8° (p < 0.001) for the femoral component. The tibial component was placed in more varus of 0.2° ± 0.9° (p = 0.056) and more posterior slope of 0.5° ± 0.9° (p < 0.001). The lower limb alignment in extension was 4.4° ± 5.2° of varus of the native knee and changed to 1.2° ± 1.9° of varus after TKA (p < 0.01). CONCLUSION Robotic-assisted TKA helps to achieve the target of alignment and component placement very close to the planning. It allows optimal component placement of off-the-shelf implants respecting patient's specific anatomy. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
- Emanuele Diquattro
- Orthopaedic-Traumatology and Prosthetic Surgery and Revisions of Hip and Knee Implants, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Robert Prill
- Department of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
- Faculty of Health Sciences, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - Mikhail Salzmann
- Department of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - Francesco Traina
- Orthopaedic-Traumatology and Prosthetic Surgery and Revisions of Hip and Knee Implants, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Roland Becker
- Department of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
- Faculty of Health Sciences, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
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Hakam HT, Prill R, Korte L, Lovreković B, Ostojić M, Ramadanov N, Muehlensiepen F. Human-Written vs AI-Generated Texts in Orthopedic Academic Literature: Comparative Qualitative Analysis. JMIR Form Res 2024; 8:e52164. [PMID: 38363631 PMCID: PMC10907945 DOI: 10.2196/52164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/09/2023] [Accepted: 12/13/2023] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND As large language models (LLMs) are becoming increasingly integrated into different aspects of health care, questions about the implications for medical academic literature have begun to emerge. Key aspects such as authenticity in academic writing are at stake with artificial intelligence (AI) generating highly linguistically accurate and grammatically sound texts. OBJECTIVE The objective of this study is to compare human-written with AI-generated scientific literature in orthopedics and sports medicine. METHODS Five original abstracts were selected from the PubMed database. These abstracts were subsequently rewritten with the assistance of 2 LLMs with different degrees of proficiency. Subsequently, researchers with varying degrees of expertise and with different areas of specialization were asked to rank the abstracts according to linguistic and methodological parameters. Finally, researchers had to classify the articles as AI generated or human written. RESULTS Neither the researchers nor the AI-detection software could successfully identify the AI-generated texts. Furthermore, the criteria previously suggested in the literature did not correlate with whether the researchers deemed a text to be AI generated or whether they judged the article correctly based on these parameters. CONCLUSIONS The primary finding of this study was that researchers were unable to distinguish between LLM-generated and human-written texts. However, due to the small sample size, it is not possible to generalize the results of this study. As is the case with any tool used in academic research, the potential to cause harm can be mitigated by relying on the transparency and integrity of the researchers. With scientific integrity at stake, further research with a similar study design should be conducted to determine the magnitude of this issue.
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Affiliation(s)
- Hassan Tarek Hakam
- Center of Orthopaedics and Trauma Surgery, University Clinic of Brandenburg, Brandenburg Medical School, Brandenburg an der Havel, Germany
- Faculty of Health Sciences, University Clinic of Brandenburg, Brandenburg an der Havel, Germany
- Center of Evidence Based Practice in Brandenburg, a JBI Affiliated Group, Brandenburg an der Havel, Germany
| | - Robert Prill
- Faculty of Health Sciences, University Clinic of Brandenburg, Brandenburg an der Havel, Germany
- Center of Evidence Based Practice in Brandenburg, a JBI Affiliated Group, Brandenburg an der Havel, Germany
| | - Lisa Korte
- Center of Health Services Research, Faculty of Health Sciences, University Clinic of Brandenburg, Rüdersdorf bei Berlin, Germany
| | - Bruno Lovreković
- Faculty of Orthopaedics, University Hospital Merkur, Zagreb, Croatia
| | - Marko Ostojić
- Departement of Orthopaedics, University Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Nikolai Ramadanov
- Center of Orthopaedics and Trauma Surgery, University Clinic of Brandenburg, Brandenburg Medical School, Brandenburg an der Havel, Germany
- Faculty of Health Sciences, University Clinic of Brandenburg, Brandenburg an der Havel, Germany
| | - Felix Muehlensiepen
- Center of Evidence Based Practice in Brandenburg, a JBI Affiliated Group, Brandenburg an der Havel, Germany
- Center of Health Services Research, Faculty of Health Sciences, University Clinic of Brandenburg, Rüdersdorf bei Berlin, Germany
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Prill R, Pieper D, Klugar M, Ayeni OR, Karlsson J, Lund H. Evidence-based research in orthopaedics, sports medicine and rehabilitation-Why new studies should rely on earlier work. Knee Surg Sports Traumatol Arthrosc 2024; 32:203-205. [PMID: 38226767 DOI: 10.1002/ksa.12047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 12/19/2023] [Indexed: 01/17/2024]
Affiliation(s)
- Robert Prill
- University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Center of Orthopaedics and Traumatology, Brandenburg an der Havel, Germany
- Brandenburg Medical School Theodor Fontane, Faculty of Health Sciences Brandenburg, Brandenburg an der Havel, Germany
| | - Dawid Pieper
- Brandenburg Medical School Theodor Fontane, Faculty of Health Sciences Brandenburg, Brandenburg an der Havel, Germany
- Brandenburg Medical School Theodor Fontane, Center for Health Services Research, Rüdersdorf, Germany
| | - Miloslav Klugar
- Cochrane Czech Republic, Czech Republic: A JBI Centre of Excellence, Czech GRADE Network, Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
- Center for Evidence-Based Education and Arts Therapies: A JBI Affiliated Group, Faculty of Education, Palacký University Olomouc, Olomouc, Czech Republic
| | - Olufemi R Ayeni
- Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Jon Karlsson
- Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hans Lund
- Section Evidence-Based Practice, Western Norway University of Applied Sciences, Bergen, Norway
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Rosen D, Reiter NL, Vogel B, Prill R. The use of systematic reviews for conducting new studies in physiotherapy research: a meta-research study comparing author guidelines of physiotherapy-related journals. Syst Rev 2024; 13:28. [PMID: 38216987 PMCID: PMC10787449 DOI: 10.1186/s13643-023-02427-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/11/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Requiring authors to base their research on a systematic review of the existing literature prevents the generation of redundant scientific studies, thereby avoiding the deprivation of effective therapies for trial participants and the waste of research funds. Scientific medical journals could require this in their author guidelines. While this applies to all areas of research, it is also relevant to physiotherapy and rehabilitation research, which predominantly involve interventional trials in patients. OBJECTIVE The aim of this study was to determine the extent to which the use of systematic reviews to justify a new trial is already being requested by physiotherapy-related scientific medical journals (PTJs). In addition, a comparison was made between PTJs and scientific medical journals with the highest impact factor in the Science Citation Index Extended (SCIE). METHODS This meta-research study is based on a systematic examination of the author guidelines of 149 PTJs. The journals were identified and included based on the number of publications with physiotherapy as a keyword in the databases PEDro, and Medline (Pubmed). The included author guidelines were analysed for the extent to which they specified that a new trial should be justified by a systematic review of the literature. Additionally, they were compared with 14 scientific medical journals with the highest impact factor in the SCIE (LJs). RESULTS In their author guidelines, none of the included PTJs required or recommended the use of a systematic review to justify a new trial. Among LJs, four journals (28.57%), all associated with the Lancet group, required the study justification through a systematic review of the literature. CONCLUSION Neither PTJs nor LJs require or recommend the use of a systematic review to justify a new trial in their author guidelines. This potentially leaves room for unethical scientific practices and should be critically considered in future research.
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Affiliation(s)
- Diane Rosen
- Centre of Evidence-Based Practice in Brandenburg: A JBI Affiliated Group, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany.
- Berlin School of Public Health, Berlin, Germany.
- Alice Salomon University of Applied Sciences Berlin, Berlin, Germany.
| | - Nils L Reiter
- Alice Salomon University of Applied Sciences Berlin, Berlin, Germany
| | - Barbara Vogel
- Department of Orthopaedics and Sports Orthopaedics, Physical Therapy, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Robert Prill
- Centre of Evidence-Based Practice in Brandenburg: A JBI Affiliated Group, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H, Germany
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Królikowska A, Reichert P, Karlsson J, Mouton C, Becker R, Prill R. Improving the reliability of measurements in orthopaedics and sports medicine. Knee Surg Sports Traumatol Arthrosc 2023; 31:5277-5285. [PMID: 37902842 PMCID: PMC10719153 DOI: 10.1007/s00167-023-07635-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 10/11/2023] [Indexed: 11/01/2023]
Abstract
A large space still exists for improving the measurements used in orthopaedics and sports medicine, especially as we face rapid technological progress in devices used for diagnostic or patient monitoring purposes. For a specific measure to be valuable and applicable in clinical practice, its reliability must be established. Reliability refers to the extent to which measurements can be replicated, and three types of reliability can be distinguished: inter-rater, intra-rater, and test-retest. The present article aims to provide insights into reliability as one of the most important and relevant properties of measurement tools. It covers essential knowledge about the methods used in orthopaedics and sports medicine for reliability studies. From design to interpretation, this article guides readers through the reliability study process. It addresses crucial issues such as the number of raters needed, sample size calculation, and breaks between particular trials. Different statistical methods and tests are presented for determining reliability depending on the type of gathered data, with particular attention to the commonly used intraclass correlation coefficient.
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Affiliation(s)
- Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Tytusa Chalubinskiego 3, 50-368, Wroclaw, Poland.
| | - Paweł Reichert
- Department of Orthopaedics, Traumatology and Hand Surgery, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Jon Karlsson
- Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Caroline Mouton
- Department of Orthopaedic Surgery, Clinique d'Eich-Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg
- Luxembourg Institute of Research in Orthopaedics, Sports Medicine and Science, Luxembourg City, Luxembourg
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
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Hakam HT, Mühlensiepen F, Salzmann M, Lettner J, Becker R, Kopf S, Prill R. Development of the INpaTiEnt Rehabilitation App Compliance QuesTionnaire [INTERACT]. J Pers Med 2023; 13:1638. [PMID: 38138865 PMCID: PMC10744598 DOI: 10.3390/jpm13121638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND The elements of previously designed questionnaires do not take into consideration the burdens encountered in an inpatient hospital setting. The purpose of this study is to validate elements of a non-compliance survey in an in-hospital setting and discuss aspects of compliance with telerehabilitative physiotherapy in the early postoperative period. METHODS A literature search was conducted to identify elements that prevent patients from performing their prescribed physical therapy exercises. These items were then evaluated by the expert review technique as described by Ikart. Afterwards, the synthesized survey was handed out to patients for the assessment of the quality of its items. RESULTS The results of the expert review technique identified some conceptual and grammatical problems. This led to the adjustment of some of the elements. The quality of the resulting questionnaire was deemed to be good, as patients were able to fully understand the concepts and answer accordingly. A statistical analysis was conducted to evaluate the responses. CONCLUSIONS The items of this second questionnaire have proven to be reliable to assess the compliance of patients in an in-hospital setting. These items will be added to the cross-culturally adapted items of a previous questionnaire.
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Affiliation(s)
- Hassan Tarek Hakam
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstr. 29, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
- Center of Evidence Based Practice in Brandenburg (EBB), A JBI Affiliated Group, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
| | - Felix Mühlensiepen
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
- Center of Evidence Based Practice in Brandenburg (EBB), A JBI Affiliated Group, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
- Center for Health Services Research, Brandenburg Medical School, 15562 Rüdersdorf, Germany
| | - Mikhail Salzmann
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstr. 29, 14770 Brandenburg an der Havel, Germany
| | - Jonathan Lettner
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstr. 29, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
- Center of Evidence Based Practice in Brandenburg (EBB), A JBI Affiliated Group, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstr. 29, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
| | - Sebastian Kopf
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstr. 29, 14770 Brandenburg an der Havel, Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstr. 29, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
- Center of Evidence Based Practice in Brandenburg (EBB), A JBI Affiliated Group, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
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11
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Kersten S, Prill R, Hakam HT, Hofmann H, Kayaalp ME, Reichmann J, Becker R. Postoperative Activity and Knee Function of Patients after Total Knee Arthroplasty: A Sensor-Based Monitoring Study. J Pers Med 2023; 13:1628. [PMID: 38138855 PMCID: PMC10744578 DOI: 10.3390/jpm13121628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/14/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023] Open
Abstract
Inertial measurement units (IMUs) are increasingly being used to assess knee function. The aim of the study was to record patients' activity levels and to detect new parameters for knee function in the early postoperative phase after TKA. Twenty patients (n = 20) were prospectively enrolled. Two sensors were attached to the affected leg. The data were recorded from the first day after TKA until discharge. Algorithms were developed for detecting steps, range of motion, horizontal, sitting and standing postures, as well as physical therapy. The mean number of steps increased from day 1 to discharge from 117.4 (SD ± 110.5) to 858.7 (SD ± 320.1), respectively. Patients' percentage of immobilization during daytime (6 a.m. to 8 p.m.) was 91.2% on day one and still 69.9% on the last day. Patients received daily continuous passive motion therapy (CPM) for a mean of 36.4 min (SD ± 8.2). The mean angular velocity at day 1 was 12.2 degrees per second (SD ± 4.4) and increased to 28.7 (SD ± 16.4) at discharge. This study shows that IMUs monitor patients' activity postoperatively well, and a wide range of interindividual motion patterns was observed. These sensors may allow the adjustment of physical exercise programs according to the patient's individual needs.
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Affiliation(s)
- Sebastian Kersten
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
- Department of Orthopaedic Surgery, Sana Kliniken Sommerfeld, 16766 Sommerfeld, Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
| | - Hassan Tarek Hakam
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
| | - Hannes Hofmann
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
| | - Mahmut Enes Kayaalp
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
- Istanbul Kartal Research and Training Hospital, 34865 Istanbul, Turkey
| | | | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
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Dehlinger F, Bökeler U, Brandt H, Brunnader L, Eden L, Pfingsten A, Prill R. The S2e Guideline on Shoulder Stiffness. Z Orthop Unfall 2023. [PMID: 37798915 DOI: 10.1055/a-2123-4952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
The clinical picture of "frozen shoulder" is still poorly understood. In order to present the current state of knowledge on aetiology, diagnosis, and treatment, and to provide recommendations for the professional groups involved, a working group was formed by the DGOU and the DVSE to create a German language, evidence-based guideline, which was published in 2022 by the AWMF. The following summarises the development and the most important results.
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Affiliation(s)
- Friedrich Dehlinger
- Departement for Shoulder and Elbow Surgery, Acura Fachklinik GmbH, Albstadt, Deutschland
| | - Ulf Bökeler
- Klinik für Orthopädie, Unfallchirurgie und Sporttraumatologie, Zentrum für Schwerbrandverletzte, Marien Hospital Stuttgart, Stuttgart, Deutschland
| | - Hanna Brandt
- Faculty of Applied Social and Health Sciences, Department Physiotherapy, Ostbayerische Technische Hochschule Regensburg, Regensburg, Deutschland
| | - Lars Brunnader
- Abteilung für Orthopädie und Traumatologie, Krankenhaus der Barmherzigen Brüder Eisenstadt, Eisenstadt, Deutschland
| | - Lars Eden
- Klinik für Unfall-, Schulter- und Wiederherstellungschirurgie, Sportmedizin und Sporttraumatologie, Krankenhaus Rummelsberg gGmbH, Schwarzenbruck, Deutschland
| | - Andrea Pfingsten
- Faculty of Applied Social and Health Sciences, Department Physiotherapy, Ostbayerische Technische Hochschule Regensburg, Regensburg, Deutschland
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Deutschland
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Neuruppin, Deutschland
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13
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Ostojic M, Winkler PW, Karlsson J, Becker R, Prill R. Minimal Clinically Important Difference: don't just look at the "p-value". Knee Surg Sports Traumatol Arthrosc 2023; 31:4077-4079. [PMID: 37460662 DOI: 10.1007/s00167-023-07512-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 07/10/2023] [Indexed: 09/01/2023]
Affiliation(s)
- Marko Ostojic
- Department of Orthopaedics, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Philipp W Winkler
- Department of Orthopaedics and Traumatology, Kepler University Hospital Linz, Linz, Austria
| | - Jon Karlsson
- Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany.
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany.
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14
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Hakam HT, Lettner J, Hofmann H, Kersten S, Muehlensiepen F, Becker R, Prill R. Non-Adherence with Physiotherapeutic Rehabilitation-A Cross-Cultural Adaption of Compliance Parameters into German. J Pers Med 2023; 13:1353. [PMID: 37763121 PMCID: PMC10532718 DOI: 10.3390/jpm13091353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Compliance with rehabilitative physiotherapeutic measures leads to an improvement in outcomes in patients suffering from a variety of musculoskeletal conditions. To date, a tool for assessing the parameters that lead to non-adherence to physical therapy does not exist in the German language. The objective of this paper is to cross-culturally adapt a non-compliance questionnaire to German. METHODS In reference to the "Guidelines for the Process of Cross-Cultural Adaption of Self-Reported Measures", the questionnaire was translated into German followed by a back-translation into the original language. An expert committee met and refined the pre-final version. A preliminary version was handed out to patients for evaluation of the quality of the resulting German version. RESULTS After the forward- and back-translation of the questionnaire, some discrepancies were discovered between the translators on the one hand and between the back-translations and the original document on the other. The statistical analysis showed satisfactory results regarding the quality of the questionnaire. CONCLUSION The translation and adaption of the items proved to have a high degree of reliability. The German version will be made available for German-speaking researchers and used for evaluating a mobile-application-based physical therapy regimen by the authors of the paper.
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Affiliation(s)
- Hassan Tarek Hakam
- Center of Orthopedics and Trauma Surgery, University Clinic of Brandenburg, Hochstr. 29, 14770 Brandenburg an der Havel, Germany; (H.H.); (S.K.)
- Medical School of Brandenburg, Fehbellinerstr 38, 16816 Neuruppin, Germany; (J.L.); (F.M.)
- Center of Evidence Based practice Brandenburg (EBB), A JBI Affiliated Group, 14770 Brandenburg an der Havel, Germany
| | - Jonathan Lettner
- Medical School of Brandenburg, Fehbellinerstr 38, 16816 Neuruppin, Germany; (J.L.); (F.M.)
| | - Hannes Hofmann
- Center of Orthopedics and Trauma Surgery, University Clinic of Brandenburg, Hochstr. 29, 14770 Brandenburg an der Havel, Germany; (H.H.); (S.K.)
- Medical School of Brandenburg, Fehbellinerstr 38, 16816 Neuruppin, Germany; (J.L.); (F.M.)
| | - Sebastian Kersten
- Center of Orthopedics and Trauma Surgery, University Clinic of Brandenburg, Hochstr. 29, 14770 Brandenburg an der Havel, Germany; (H.H.); (S.K.)
- Department of Orthopaedic Surgery, Sana Kliniken Sommerfeld, 16766 Kremmen, Germany
| | - Felix Muehlensiepen
- Medical School of Brandenburg, Fehbellinerstr 38, 16816 Neuruppin, Germany; (J.L.); (F.M.)
- Center of Evidence Based practice Brandenburg (EBB), A JBI Affiliated Group, 14770 Brandenburg an der Havel, Germany
- Center for Health Services Research, Faculty for Health Sciences, University Clinic of Brandenburg, Seebad 82/83, 15562 Rüdersdorf bei Berlin, Germany
| | - Roland Becker
- Center of Orthopedics and Trauma Surgery, University Clinic of Brandenburg, Hochstr. 29, 14770 Brandenburg an der Havel, Germany; (H.H.); (S.K.)
- Medical School of Brandenburg, Fehbellinerstr 38, 16816 Neuruppin, Germany; (J.L.); (F.M.)
| | - Robert Prill
- Center of Orthopedics and Trauma Surgery, University Clinic of Brandenburg, Hochstr. 29, 14770 Brandenburg an der Havel, Germany; (H.H.); (S.K.)
- Medical School of Brandenburg, Fehbellinerstr 38, 16816 Neuruppin, Germany; (J.L.); (F.M.)
- Center of Evidence Based practice Brandenburg (EBB), A JBI Affiliated Group, 14770 Brandenburg an der Havel, Germany
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Avram GM, Prill R, Gurau CD, Georgeanu V, Deleanu B, Russu O, Becker R, Predescu V. Acetabular cup placement and offset control in robotic total hip arthroplasty performed through the modified anterolateral approach. Int Orthop 2023; 47:2265-2273. [PMID: 37160646 DOI: 10.1007/s00264-023-05835-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 05/01/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE The modified anterolateral approach (Röttinger) for total hip arthroplasty (THA) offers great advantages over conventional approaches, especially concerning early postoperative symptoms, which are mild and well tolerated by patients. Robotic-assisted implantation might facilitate rapid adoption of the modified anterolateral approach without exposing surgeons to risks encountered during the learning curve. This study posits that the use of robotic assistance in conjunction with the modified anterolateral approach for total hip arthroplasty (THA) can provide a substantial enhancement in the accuracy of cup placement in comparison to manual surgery. METHODS Thirty-two robotic-assisted THAs met the inclusion criteria and were matched to 32 conventional cases. Acetabular cup inclination, anteversion, limb-length discrepancy, and acetabular offset were assessed using certified planning software by two independent observers using pre- and postoperative anterior-posterior radiographs. Data was analyzed for normal distribution. Chi2 test was used to determine whether implanted acetabular cups that were within Lewinnek's safe zones were influenced by type of implantation. Effect size estimates and statistical power analysis were also performed to appreciate the appropriateness of the chosen sample size. RESULTS Robotic-assisted implantation was found to significantly improve acetabular cup placement in terms of inclination (p < 0.001) but not anteversion (p = 0.783). Although mean postoperative limb-length discrepancy and mean acetabular offset did not differ between groups, a significantly smaller variance was found in the robotic-assisted group (p < 0.001) and (p = 0.04), respectively. There were no significant differences between the two groups in terms of consistently implanting the acetabular cup within the Lewinnek safe zones p = 0.641 for anteversion and p = 0.230 for inclination, respectively. CONCLUSIONS Our results show that although robotic-assisted acetabular cup implantation performed through the modified anterolateral approach did not significantly differ from conventional implantation, it did offer increased accuracy in cup positioning, acetabular bone preservation, and limb-length restoration.
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Affiliation(s)
- George Mihai Avram
- Orthopaedics and Traumatology Department, Ponderas Academic Hospital, 014142, Bucharest, Romania.
| | - Robert Prill
- Center of Orthopaedics and Traumatology, Brandenburg Medical School Theodor Fontane, University Hospital Brandenburg/Havel, 14770, Brandenburg a.d.H, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770, Brandenburg a.d.H, Germany
| | - Cristian Dorin Gurau
- Orthopaedics and Traumatology Department, Ponderas Academic Hospital, 014142, Bucharest, Romania
| | - Vlad Georgeanu
- Orthopaedics and Traumatology Department, Clinical Emergency Hospital St. Pantelimon, Bucharest, Romania
| | - Bogdan Deleanu
- Orthopaedics and Traumatology Department, University of Medicine and Pharmacy Victor Babes, Timisoara, Romania
| | - Octav Russu
- Orthopaedic and Traumatology Department, Pharmacy, Sciences and Technology George Emil Palade, University of Medicine, 540139, Targu Mures, Romania
| | - Roland Becker
- Center of Orthopaedics and Traumatology, Brandenburg Medical School Theodor Fontane, University Hospital Brandenburg/Havel, 14770, Brandenburg a.d.H, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770, Brandenburg a.d.H, Germany
| | - Vlad Predescu
- Orthopaedics and Traumatology Department, Ponderas Academic Hospital, 014142, Bucharest, Romania
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Adriani M, Becker R, Milano G, Lachowski K, Prill R. High variation among clinical studies in the assessment of physical function after knee replacement: a systematic review. Knee Surg Sports Traumatol Arthrosc 2023; 31:3854-3860. [PMID: 36907938 PMCID: PMC10435639 DOI: 10.1007/s00167-023-07375-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/27/2023] [Indexed: 03/14/2023]
Abstract
PURPOSE The purpose of this study was to summarise the current use of outcome measures for the assessment of physical function after knee joint replacement. METHODS A systematic approach following the PRISMA guidelines was used. Literature search was performed on MEDLINE database via PubMed and on Epistemonikos. Clinical trials (level of evidence I-II) on knee joint replacement reporting data on the 'physical function' domain published between January 2017 and June 2022 were included. Descriptive statistics were used to summarise the evidence. RESULTS In the 181 articles that met the inclusion criteria, 49 different outcome measurements were used to evaluate clinical outcomes after knee joint replacement. The most frequently adopted patient-reported outcome measures (PROMs) were the Knee Society Score (KSS) (78 studies; 43.1%), the Western Ontario and McMaster Universities (WOMAC) Arthritis Index (62 studies; 34.3%), the Oxford Knee Score (OKS) (51 studies; 28.2%) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) (36 studies; 20%). The most frequently used performance-based outcome measures (PBOMs) were the Timed-Up-and-Go (TUG) test (30 studies; 16.6%) and the 6-min-walk test (6MWT) (21 studies; 11.6%). Among impairment-based outcome measures (IBOMs), range of motion (ROM) was the most used (74 studies; 40.9%). CONCLUSION There is considerable variation among clinical studies regarding the assessment of the physical function of patients after knee joint replacement. PROMs were found to be the most commonly adopted outcome measures; however, no single PROM was used in more than half of the papers analysed. LEVEL OF EVIDENCE Level II, systematic review of level I-II studies.
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Affiliation(s)
- Marco Adriani
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
| | - Giuseppe Milano
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Krzysztof Lachowski
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
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17
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Kirschner J, Michel S, Becker R, Stiebitz O, Hommel H, Schulz R, Daszkiewicz M, Królikowska A, Prill R. Determination of Relationships between Symmetry-Based, Performance-Based, and Functional Outcome Measures in Patients Undergoing Total Hip Arthroplasty. J Pers Med 2023; 13:1046. [PMID: 37511659 PMCID: PMC10381123 DOI: 10.3390/jpm13071046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/06/2023] [Accepted: 06/23/2023] [Indexed: 07/30/2023] Open
Abstract
Due to the high heterogeneity in outcome measures after total hip arthroplasty (THA), the prospective observational study investigated the relationships between symmetry-based (SBMs), performance-based (PBMs), and functional outcome measures in THA patients to determine necessary or redundant categories of tests. The study material consisted of 24 patients with end-stage hip osteoarthritis scheduled for THA. The patients were examined one day before surgery and consecutively on the 4th day, 9th day, and 10th week postoperatively using the SBMs (weight-bearing chair-rising test, measurements of the maximal isometric torque of the quadriceps muscle); the PBMs (10-m walk, timed up-and-go, and stair-climbing tests); and the functional outcome measure (Harris Hip Score). The results obtained in a given category of tests at different time points were compared, and the correlations between the tests were determined. The reliability of the outcome measures was determined. The results of tests in the studied categories statistically significantly (p < 0.05) improved at the 10th week postoperatively compared to preoperative results. No strong correlations were revealed between the three studied types of outcome measures in THA patients. Therefore, none of them can be considered redundant. It also means that the relevance of symmetry for a core measurement set to describe the domain function in THA patients must be further clarified.
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Affiliation(s)
- Jana Kirschner
- Department of Therapy Sciences, Brandenburg University of Technology Cottbus-Senftenberg, 03046 Cottbus, Germany
| | - Sven Michel
- Department of Therapy Sciences, Brandenburg University of Technology Cottbus-Senftenberg, 03046 Cottbus, Germany
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg a.d.H., Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
| | - Olaf Stiebitz
- Department of Therapy Sciences, Brandenburg University of Technology Cottbus-Senftenberg, 03046 Cottbus, Germany
| | - Hagen Hommel
- Department of Therapy Sciences, Brandenburg University of Technology Cottbus-Senftenberg, 03046 Cottbus, Germany
- District Hospital Märkisch Oderland GmbH, 16269 Wriezen, Germany
| | - Robert Schulz
- BIH QUEST Center for Responsible Research, Berlin Institute of Health at Charité, Universitätsmedizin Berlin, 10178 Berlin, Germany
| | | | - Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, 50367 Wroclaw, Poland
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg a.d.H., Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
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18
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Prill R, Mouton C, Klugorová J, Królikowska A, Karlsson J, Becker R. Implementation of evidence-based medicine in everyday clinical practice. Knee Surg Sports Traumatol Arthrosc 2023:10.1007/s00167-023-07468-y. [PMID: 37272992 DOI: 10.1007/s00167-023-07468-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/23/2023] [Indexed: 06/06/2023]
Affiliation(s)
- Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany.
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany.
| | - Caroline Mouton
- Department of Orthopaedic Surgery, Clinique d'Eich - Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
- Luxembourg Institute of Research in Orthopaedics, Sports Medicine and Science, Luxembourg, Luxembourg
| | - Jitka Klugorová
- Institute of Biostatistics and Analyses, Faculty of Medicine, Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (The Czech Republic Centre for Evidence-Based Healthcare: The JBI Centre of Excellence, Cochrane Czech Republic, Masaryk University GRADE Centre), Masaryk University, Brno, Czech Republic
| | - Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Jon Karlsson
- Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
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Prill R, Królikowska A, de Girolamo L, Becker R, Karlsson J. Checklists, risk of bias tools, and reporting guidelines for research in orthopedics, sports medicine, and rehabilitation. Knee Surg Sports Traumatol Arthrosc 2023:10.1007/s00167-023-07442-8. [PMID: 37145131 DOI: 10.1007/s00167-023-07442-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 04/24/2023] [Indexed: 05/06/2023]
Affiliation(s)
- Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H, Germany.
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H, Germany.
| | - Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Laura de Girolamo
- Orthopaedic Biotechnology Laboratory, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H, Germany
| | - Jon Karlsson
- Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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20
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Anzola LK, Hernandez N, Rodriguez LF, Sanguino G, Martinez E, Lopez R, Moreno S, Prill R, Mut F, Rasch H, Hirschmann M. The role of SPECT/CT in painful, noninfected knees after knee arthroplasty: a systematic review and meta-analysis-a diagnostic test accuracy review. J Orthop Surg Res 2023; 18:223. [PMID: 36945001 PMCID: PMC10031962 DOI: 10.1186/s13018-023-03687-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 03/07/2023] [Indexed: 03/23/2023] Open
Abstract
PURPOSE The aim of this systematic review was to present the current evidence on the clinical use of single-photon emission computed tomography/computed tomography (SPECT/CT) in the evaluation of noninfected painful knees after knee arthroplasty. METHODS Embase, PubMed, Google Scholar, Ovid, Scopus, Science Direct and the Cochrane Database of Systematic Reviews were searched from database inception to May 2022 following the PRISMA guidelines. As a primary outcome, we defined the role of SPECT/CT in the diagnostic approach to noninfected painful knee arthroplasty; as a secondary objective, we described the noninfection-related factors linked to painful knee arthroplasty. Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio values and other indicators were calculated; receiver operating characteristic (ROC) curve analysis results and a summary of the areas under the curve (AUCs) from the included studies were reported. A Fagan plot, likelihood ratio plot and Deeks' funnel plot were generated and analysed. Methodological quality was assessed using the QUADAS-2 tool, and the certainty of evidence was assessed by the GRADE approach. RESULTS A total of 493 publications were identified, of which eight met the inclusion criteria, with a final pooled sample size of 308 patients. The pooled sensitivity and specificity of SPECT/CT in diagnosing the source of pain in painful knee prostheses were 0.86 (95% CI: 0.75-0.93) and 0.90 (95% CI: 0.79-0.96), respectively, with pooled +LR and -LR values of 8.9 (95% CI: 4.11-19.19) and 0.15 (95% CI: 0.09-0.28). The pooled diagnostic odds ratio was 57.35, and the area under the curve was 0.94. SPECT/CT highly accurately identified different sources of pain, such as loosening of the prosthetic components, patellofemoral overloading, instability, malalignment of the components and degeneration of the patellofemoral compartment. The confidence of the estimates was moderate according to the GRADE approach. CONCLUSION With demonstrated high sensitivity and specificity, as a diagnostic tool, SPECT/CT can identify the source of pain in painful knees after knee arthroplasty, particularly in cases of loosening, patellofemoral disorders and component malalignment (level of evidence III). These findings have significant clinical repercussions, such as in changing the initial diagnosis, identifying or excluding different causes of painful knee arthroplasties, guiding subsequent treatment and positively impacting the final clinical outcome. We moderately recommend the use of SPECT/CT for identifying the source of pain after knee arthroplasty according to the GRADE assessment. This review was preregistered in Prospero under code CRD42022320457.
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Affiliation(s)
- Luz Kelly Anzola
- Department of Nuclear Medicine, Clinica Reina Sofia, Bogota, Colombia.
- Department of Nuclear Medicine, Clinica Colombia, Bogota, Colombia.
- Fundacion Universitaria Sanitas Nuclear Medicine Postgraduate Program, Bogota, Colombia.
| | - Nathaly Hernandez
- Fundacion Universitaria Sanitas Nuclear Medicine Postgraduate Program, Bogota, Colombia
| | | | - Gilberto Sanguino
- Department of Orthopedics and Traumatology, Clinica Reina Sofia, Bogota, Colombia
| | - Ernesto Martinez
- Department of Orthopedics and Traumatology, Clinica Reina Sofia, Bogota, Colombia
| | - Rodrigo Lopez
- Department of Orthopedics and Traumatology, Clinica Reina Sofia, Bogota, Colombia
| | - Sergio Moreno
- Clinical Epidemiologist, Universidad Nacional de Colombia, Bogota, Colombia
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodore Fontane, Neuruppin, Germany
| | - Fernando Mut
- Department of Nuclear Medicine, Hospital Italiano, Montevideo, Uruguay
| | - Helmut Rasch
- Institute for Radiology and Nuclear Medicine, Kantonsspital Baselland, 4101, Bruderholz, Switzerland
| | - Michael Hirschmann
- Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland, 4101, Bruderholz, Switzerland
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21
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Kühn L, Lindert L, Kuper P, Prill R, Choi KE(A. Research designs and instruments to detect physiotherapy overuse of low-value care services in low back pain management: a scoping review. BMC Health Serv Res 2023; 23:193. [PMID: 36823581 PMCID: PMC9949696 DOI: 10.1186/s12913-023-09166-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 02/09/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND The provision of low-value physiotherapy services in low back pain management is a known but complex phenomenon. Thus, this scoping review aims to systematically map existing research designs and instruments of the field in order to discuss the current state of research methodologies and contextualize results to domains and perspectives of a referred low-value care typology. Ultimately, results will be illustrated and transferred to conditions of the German health care setting as care delivery conditions of physiotherapy in Germany face unique particularities. METHODS The development of this review is guided by the analysis framework of Arksey and O'Malley. A two-stage, audited search strategy was performed in Medline (PubMed), Web of Science, and google scholar. All types of observational studies were included. Identified articles needed to address a pre-determined population, concept, and context framework and had to be published in English or German language. The publication date of included articles was not subject to any limitation. The applied framework to assess the phenomenon of low-value physiotherapy services incorporated three domains (care effectiveness; care efficiency; patient alignment of care) and perspectives (provider; patient; society) of care. RESULTS Thirty-three articles met the inclusion criteria. Seventy-nine percent of articles focused on the appropriateness of physiotherapeutic treatments, followed by education and information (30%), the diagnostic process (15%), and goal-setting practice (12%). Study designs were predominantly cross-sectional (58%). Data sources were mainly survey instruments (67%) of which 50% were self-developed. Most studies addressed the effectiveness domain of care (73%) and the provider perspective (88%). The perspective of patient alignment was assessed by 6% of included articles. None of included articles assessed the society perspective. Four methodical approaches of included articles were rated to be transferrable to Germany. CONCLUSION Identified research on low-value physiotherapy care in low back pain management was widely unidimensional. Most articles focused on the effectiveness domain of care and investigated the provider perspective. Most measures were indirectly and did not monitor low-value care trends over a set period of time. Research on low-value physiotherapy care in secondary care conditions, such as Germany, was scarce. REGISTRATION This review has been registered on open science framework ( https://osf.io/vzq7k https://doi.org/10.17605/OSF.IO/PMF2G ).
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Affiliation(s)
- Lukas Kühn
- Center for Health Services Research, Seebad 82/83, 15562 Rüdersdorf Bei Berlin, Brandenburg Medical School, Neuruppin, Germany. .,Faculty of Health Sciences Brandenburg, Brandenburg Medical School, Fehrbelliner Straße 38, 16816, Neuruppin, Germany.
| | - Lara Lindert
- grid.473452.3Center for Health Services Research, Seebad 82/83, 15562 Rüdersdorf Bei Berlin, Brandenburg Medical School, Neuruppin, Germany
| | - Paulina Kuper
- grid.473452.3Center for Health Services Research, Seebad 82/83, 15562 Rüdersdorf Bei Berlin, Brandenburg Medical School, Neuruppin, Germany
| | - Robert Prill
- grid.473452.3Faculty of Health Sciences Brandenburg, Brandenburg Medical School, Fehrbelliner Straße 38, 16816 Neuruppin, Germany ,grid.473452.3Center of Orthopaedics and Traumatology, Universtiy Hospital Brandenburg/Havel, Brandenburg Medical School, Neuruppin, Germany
| | - Kyung-Eun (Anna) Choi
- grid.473452.3Center for Health Services Research, Seebad 82/83, 15562 Rüdersdorf Bei Berlin, Brandenburg Medical School, Neuruppin, Germany ,grid.473452.3Faculty of Health Sciences Brandenburg, Brandenburg Medical School, Fehrbelliner Straße 38, 16816 Neuruppin, Germany ,grid.465811.f0000 0004 4904 7440Health Services Research, Faculty of Medicine/Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems-Stein, Austria
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22
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Höher J, Lischke B, Petersen W, Mengis N, Niederer D, Stein T, Stoffels T, Prill R, Schmidt-Lucke C. Sensor-based telerehabilitation system increases patient adherence after knee surgery. PLOS Digit Health 2023; 2:e0000175. [PMID: 36812639 PMCID: PMC9937459 DOI: 10.1371/journal.pdig.0000175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 12/02/2022] [Indexed: 02/19/2023]
Abstract
OBJECTIVES Implementing evidence-based recommendations with the option of patient-individualised and situation-specific adaptations in telerehabilitation may increase adherence with improved clinical outcome. METHODS As part of a registry-embedded hybrid design (part 1), digital medical device (DMD)-usage in a home-based setting was analysed in a multinational registry. The DMD combines an inertial motion-sensor system with instructions for exercises and functional tests on smartphones. A prospective, single-blinded, patient-controlled, multicentre intervention study (DRKS00023857) compared implementation capacity of the DMD to standard physiotherapy (part 2). Usage patterns by health care providers (HCP) were assessed (part 3). RESULTS AND CONCLUSION Registry raw data (10,311 measurements) were analysed from 604 DMD-users, demonstrating clinically expected rehabilitation progression post knee injuries. DMD-users performed tests for range-of-motion, coordination and strength/speed enabling insight to stage-specific rehabilitation (χ2 = 44.9, p<0.001). Intention-to-treat-analysis (part 2) revealed DMD-users to have significantly higher adherence to the rehabilitation intervention compared to the matched patient-control-group (86% [77-91] vs. 74% [68-82], p<0.05). DMD-users performed recommended exercises at home with higher intensity (p<0.05). HCP used DMD for clinical decision making. No adverse events related to the DMD were reported. Adherence to standard therapy recommendations can be increased using novel high quality DMD with high potential to improve clinical rehabilitation outcome, enabling evidence-based telerehabilitation.
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Affiliation(s)
- Jürgen Höher
- Sportsclinic Cologne, Cologne, Germany
- Department for Orthopedics and Sports Traumatology, Merheim Hospital Cologne, University of Witten-Herdecke, Germany
- * E-mail:
| | - Betty Lischke
- MEDIACC (Medico-academic Consultings), Berlin, Germany
| | | | | | - Daniel Niederer
- Department of Sports Medicine and Exercise Physiology, Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Thomas Stein
- Department of Sports Medicine and Exercise Physiology, Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt, Frankfurt am Main, Germany
- SPORTHOLOGICUM Frankfurt—Center for Sport and Joint Injuries, Frankfurt am Main, Germany
| | - Thomas Stoffels
- OC Stadtmitte—Practice for Orthopedics & Surgery, Berlin, Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, Brandenburg Medical School, University Hospital Brandenburg/Havel, Germany
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23
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Królikowska A, Maj A, Dejnek M, Prill R, Skotowska-Machaj A, Kołcz A. Wrist motion assessment using Microsoft Azure Kinect DK: A reliability study in healthy individuals. ADV CLIN EXP MED 2023; 32:203-209. [PMID: 36135819 DOI: 10.17219/acem/152884] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/01/2022] [Accepted: 08/18/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Motion analysis systems have been widely used in orthopedics and rehabilitation for diagnostics, patient monitoring and outcome evaluation purposes. Since Microsoft Azure Kinect Developer Kit (DK) had been released, only a few studies were published concerning its usage. However, it has not been used for wrist motion assessments, even though the use of standardized examinations with known reliability, validity and responsiveness remains a constant challenge. OBJECTIVES This study aimed to examine the reliability of hand and forearm range of motion (ROM) measurements recorded using new software utilizing the Microsoft Azure Kinect DK. MATERIAL AND METHODS Twenty-eight healthy males and 28 healthy females participated in measurements of active ROM for wrist extension, wrist flexion, radial deviation, ulnar deviation, and forearm supination and pronation on 3 separate occasions. Sessions 1 and 2 were carried out on the same day with a 90-minute rest period between each session, while the 3rd session was conducted a week later. Data were recorded simultaneously in both limbs using a custom-made software developed by a software development company (Oleksy Medical & Sports Sciences, Łańcut, Poland) for the purposes of the present study using Microsoft Azure Kinect DK. The assessment of intra-day and inter-day reliability was based on intraclass correlation coefficient (ICC) calculations and interpreted based on commonly used guidelines. RESULTS In the group of males, the lowest ICC was 0.846 for intra-day comparisons and 0.816 for inter-day analyses. In the female group, the lowest ICC for intra-day comparisons was 0.826 and exceeded 0.833 for inter-day comparisons. CONCLUSIONS The developed software using Microsoft Azure Kinect DK demonstrated high reliability in measuring wrist and forearm active ROM. These promising results support the use of Microsoft Azure Kinect DK in a clinical capacity as a potential hand assessment and rehabilitation tool.
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Affiliation(s)
- Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Poland
| | - Agnieszka Maj
- Clinical Department of Trauma and Hand Surgery, Jan Mikulicz-Radecki University Hospital, Wrocław, Poland
| | - Maciej Dejnek
- Clinical Department of Trauma and Hand Surgery, Jan Mikulicz-Radecki University Hospital, Wrocław, Poland.,Department of Trauma Surgery, Faculty of Medicine, Wroclaw Medical University, Poland
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel Brandenburg Medical School, Brandenburg an der Havel, Germany
| | - Anna Skotowska-Machaj
- Department of Rehabilitation, Primate Cardinal Wyszyński Regional Hospital, Sieradz, Poland
| | - Anna Kołcz
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Poland
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Lachowski K, Hammermeister F, Halenz B, Lieckefett F, Götze T, Prill R, Becker R. The Patellostabilometer: A New Device for Quantification of Mediolateral Patella Displacement. Sensors (Basel) 2023; 23:1274. [PMID: 36772314 PMCID: PMC9920919 DOI: 10.3390/s23031274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Mediolateral patella displacement is of interest for diagnostics and clinically relevant research questions. Apart from manual testing, no standardized method is currently available. Proper quantification of patella mobility is necessary to better understand pathologies at the patellofemoral joint. Patella mobility was assessed in 25 healthy individuals using a Patellostabilometer, a new prototype instrument for quantification of the mediolateral patella displacement. The participants underwent measurements of the mediolateral displacement three times using the Patellostabilometer. A maximal force of 10 N was applied for patella movement. Additionally, leg length and circumference of the knee, upper- and lower-leg were measured. Lateral patella displacement of 18.27 ± 3.76 mm (range 15.85-20.64 mm, interquartile range (IQR) of 4.79) was measured. The medial patella displacement showed 24.47 ± 6.59 mm (range 19.29-29.76 mm, IQR of 10.47). The test-retest measurement error was 2.32 ± 1.76 mm (IQR of 2.38 mm), with five outliers. There was greater test-retest variability between the measurements of the medial displacement compared to the lateral one. The test-retest variability reached 7% of the patella displacement. Other parameters provided no significant correlations. Based on the natural patellofemoral mobility, a precise and clinically relevant quantification of patella mobility is allowed.
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Affiliation(s)
- Krzysztof Lachowski
- Center of Orthopaedics and Traumatology, Brandenburg Medical School Theodor Fontane, University Hospital Brandenburg/Havel, 14770 Brandenburg a.d.H., Germany
| | - Florian Hammermeister
- Technical Faculty, Brandenburg University of Applied Sciences, 14770 Brandenburg a.d.H., Germany
| | - Bastian Halenz
- Technical Faculty, Brandenburg University of Applied Sciences, 14770 Brandenburg a.d.H., Germany
| | - Florian Lieckefett
- Technical Faculty, Brandenburg University of Applied Sciences, 14770 Brandenburg a.d.H., Germany
| | - Thomas Götze
- Technical Faculty, Brandenburg University of Applied Sciences, 14770 Brandenburg a.d.H., Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, Brandenburg Medical School Theodor Fontane, University Hospital Brandenburg/Havel, 14770 Brandenburg a.d.H., Germany
- Faculty of Health Science Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg a.d.H., Germany
| | - Roland Becker
- Center of Orthopaedics and Traumatology, Brandenburg Medical School Theodor Fontane, University Hospital Brandenburg/Havel, 14770 Brandenburg a.d.H., Germany
- Faculty of Health Science Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg a.d.H., Germany
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25
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Królikowska A, Kusienicka K, Lazarek E, Oleksy Ł, Prill R, Kołcz A, Daszkiewicz M, Janczak D, Reichert P. A Randomized, Double-Blind Placebo Control Study on the Effect of a Blood Flow Restriction by an Inflatable Cuff Worn around the Arm on the Wrist Joint Position Sense in Healthy Recreational Athletes. J Clin Med 2023; 12:jcm12020602. [PMID: 36675531 PMCID: PMC9867391 DOI: 10.3390/jcm12020602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
The number of blood flow restriction (BFR) training practitioners is rapidly increasing, so understanding the safety issues associated with limb occlusion is strongly needed. The present study determined the effect of BFR by an inflatable cuff worn around the arm on the wrist joint position sense (JPS) in healthy recreational athletes. In the prospective randomized, double-blind placebo control study, sixty healthy right-handed recreational athletes aged x = 22.93 ± 1.26 years were assigned to groups of equal size and gender rates: BFR, placebo, and control. The active wrist JPS was assessed in two separate sessions using an isokinetic dynamometer. The first assessment was performed with no cuffs. In the second session, a cuff with a standardized pressure was worn on the examined limb in the BFR group. In the placebo group, the cuff was uninflated. A between-session comparison in each group of collected angular errors expressed in degrees was carried out. The angular error in the BFR group was larger during the second measurement than the first one (p = 0.011-0.336). On the contrary, in the placebo (p = 0.241-0.948) and control (p = 0.093-0.904) groups, the error value in the second session was comparable or smaller. It was determined that BFR by an inflatable cuff around the arm impairs the wrist position sense. Hence, BFR training should be performed with caution.
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Affiliation(s)
- Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, 50-367 Wroclaw, Poland
- Correspondence: ; Tel.: +48-733-981-189
| | - Klaudia Kusienicka
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Ewa Lazarek
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Łukasz Oleksy
- Oleksy Medical & Sports Sciences, 37-100 Łańcut, Poland
- Department of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Kraków, Poland
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg a.d.H., Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg a.d.H., Germany
| | - Anna Kołcz
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Maciej Daszkiewicz
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Dariusz Janczak
- Department of Vascular, General, and Transplantation Surgery, Faculty of Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Paweł Reichert
- Department of Trauma Surgery, Clinical Department of Trauma and Hand Surgery, Faculty of Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland
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26
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Prill R, Królikowska A, Becker R, Karlsson J. Why there is a need to improve evaluation standards for clinical studies in orthopaedic and sports medicine. Knee Surg Sports Traumatol Arthrosc 2023; 31:4-5. [PMID: 36123444 DOI: 10.1007/s00167-022-07179-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 02/03/2023]
Affiliation(s)
- Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770, Brandenburg, Germany. .,Faculty of Health Sciences Brandenburg, Department of Orthopaedics and Traumatology, Brandenburg Medical School Theodor Fontane, Hochstrasse 29, 14770, Brandenburg, Germany.
| | - Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, 50-367, Wroclaw, Poland
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770, Brandenburg, Germany.,Faculty of Health Sciences Brandenburg, Department of Orthopaedics and Traumatology, Brandenburg Medical School Theodor Fontane, Hochstrasse 29, 14770, Brandenburg, Germany
| | - Jón Karlsson
- Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Prill R, Królikowska A, Becker R, Karlsson J. Correction to: Why there is a need to improve evaluation standards for clinical studies in orthopaedic and sports medicine. Knee Surg Sports Traumatol Arthrosc 2023; 31:6. [PMID: 36318323 DOI: 10.1007/s00167-022-07199-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770, Brandenburg, Germany.
- Faculty of Health Sciences Brandenburg, Department of Orthopaedics and Traumatology, Brandenburg Medical School Theodor Fontane, Hochstrasse 29, 14770, Brandenburg, Germany.
| | - Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, 50-367, Wroclaw, Poland
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770, Brandenburg, Germany
- Faculty of Health Sciences Brandenburg, Department of Orthopaedics and Traumatology, Brandenburg Medical School Theodor Fontane, Hochstrasse 29, 14770, Brandenburg, Germany
| | - Jón Karlsson
- Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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28
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Schlüter IM, Prill R, Królikowska A, Cruysen C, Becker R. A Pilot Study on the Reliability of Ultrasound-Based Assessment of Patella Diameter and Sulcus Angle. Diagnostics (Basel) 2022; 12:diagnostics12123164. [PMID: 36553171 PMCID: PMC9777322 DOI: 10.3390/diagnostics12123164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
This pilot study aimed to determine the reliability of a newly developed ultrasound-based protocol for the assessment of patella diameter and sulcus angle. The diameter of the patella expressed in mm and the sulcus angle, expressed in degrees were measured in the right knee in 12 healthy participants (eight women and four men) in two separate sessions by two examiners (experienced rater and inexperienced rater) using ultrasonography according to a developed standardized protocol. The reliability was determined on the calculated intraclass correlation coefficient, ICC, expressed as a 95% confidence interval (lower bound, upper bound). For the patella diameter measurement, intra-rater and inter-rater reliability were good to excellent, with the ICC exceeding 0.836-0.998 and 0.859-0.997, respectively. The intra-rater and inter-rater reliability of the sulcus measurement was moderate to excellent, as the ICC amounted to 0.559-0.993 and 0.559-0.990, respectively. The reliability of both measures increased with the experience of the examiner. Therefore, it was determined that the newly developed protocol for an ultrasound-based assessment of patella diameter and sulcus angle is reliable. Further studies validating their clinical use should be carried out.
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Affiliation(s)
- Isa-Maria Schlüter
- Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
- Correspondence:
| | - Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Caren Cruysen
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
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29
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Prill R, Kayaalp ME, Królikowska A, Becker R, Ayeni O, Langaufová A, Klugar M. Effects of physiotherapy interventions for home-based rehabilitation on physical function after primary total knee arthroplasty: a systematic review protocol. JBI Evid Synth 2022; 20:3017-3024. [PMID: 35976230 DOI: 10.11124/jbies-21-00355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The objective of this review is to provide a systematic and transparent overview of the effects of common physiotherapy techniques and exercises for the rehabilitation of patients following total knee arthroplasty. INTRODUCTION Many protocols exist for the rehabilitation of patients after total knee arthroplasty, but there is a lack of systematic evidence on rehabilitation components, including precise exercise descriptions and their parameters. This review will fill in some of the gaps in reporting on scientific rehabilitation protocol components and the evaluation of their effectiveness. INCLUSION CRITERIA We will include randomized controlled trials investigating active and passive physiotherapy techniques and exercises employed after primary total knee arthroplasty, and which report concrete parameters, such as dosage, duration, frequency, intensity, and function-related measurements. We will exclude other study types and randomized controlled trials reporting on techniques and exercises without precise descriptions. METHODS This review will aim to find both published and unpublished studies. The key information sources to be searched are MEDLINE (PubMed), Embase (Ovid), CINAHL (EBSCO), PEDro, Cochrane CENTRAL, ClinicalTrials.gov, and WHO International Clinical Trials Registry Platform. Two independent reviewers will screen titles, abstracts, and full texts; assess the methodological quality; and extract the data. We will perform narrative synthesis, followed by meta-analyses for pooled studies, where possible. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022309185.
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Affiliation(s)
- Robert Prill
- Department of Orthopedics and Traumatology, Centre of Joint Replacement West Brandenburg, University of Brandenburg an der Havel Theodor Fontane, Brandenburg an der Havel, Germany
| | - Mahmut Enes Kayaalp
- Department of Orthopedics and Traumatology, Centre of Joint Replacement West Brandenburg, University of Brandenburg an der Havel Theodor Fontane, Brandenburg an der Havel, Germany
- Istanbul Taksim Training and Research Hospital, Istanbul, Turkey
| | - Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
| | - Roland Becker
- Department of Orthopedics and Traumatology, Centre of Joint Replacement West Brandenburg, University of Brandenburg an der Havel Theodor Fontane, Brandenburg an der Havel, Germany
| | - Olufemi Ayeni
- Division of Orthopedics, McMaster University, Hamilton, ON, Canada
| | - Alena Langaufová
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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Prill R, Cruysen C, Królikowska A, Kopf S, Becker R. Knee Orthotics Do Not Influence Coordinative Skills—A Randomized Controlled Crossover Pilot Trial. J Pers Med 2022; 12:jpm12091509. [PMID: 36143292 PMCID: PMC9503396 DOI: 10.3390/jpm12091509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/08/2022] [Accepted: 09/11/2022] [Indexed: 11/25/2022] Open
Abstract
Objective: This single-blind randomized controlled crossover pilot trial investigated whether hard or soft knee orthotics affect the back in action (BIA) test battery performance. Methods: Twenty-four healthy participants (13 males, 11 females) were randomly assigned into three equal groups differentiated through the order of device use. The data were collected in a laboratory setting. BIA test battery (balance tests, vertical jumps, and parkour hop tests) was run with a rigid orthotic device, a soft brace, or no aid in a crossover order. Analysis of Variance repeated measures and Friedman Test were used to calculate depended-group differences. Results: No significant or clinically relevant effect or differences was observed between running the BIA with a soft brace, rigid orthosis, or no aid (p = 0.53–0.97) for all included tests. No adverse events have been observed. Conclusion: Soft and rigid knee braces do not affect performance in healthy participants. Missing experience with the devices might explain a few influences on feedback mechanisms. There is no disadvantage to be expected regarding healthy participants running back to sports.
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Affiliation(s)
- Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
- Correspondence:
| | - Caren Cruysen
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
| | - Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Sebastian Kopf
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany
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Prill R, Becker R, Schulz R, Michel S, Hommel H. No correlation between symmetry-based performance measures and patient-related outcome prior to and after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2022; 30:3155-3161. [PMID: 33881572 DOI: 10.1007/s00167-021-06570-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/06/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE Standardized outcome measures are crucial for the evaluation of different treatment and rehabilitation regimes in patients after total knee arthroplasty (TKA). Performance-based measures are necessary to capture different aspects of physical function. High reliability and agreement of five performance-based measures were hypothesized to differentiate between measurement error and change in test performance. Secondary outcomes are the correlation of performance-based measurements to KSS and WOMAC prior to surgery (baseline) and 10 weeks thereafter (t3). METHODS The test-retest reliabilities and agreements of the 1-m walk test, the stair-climbing test, the timed-up-and-go test, the weight-balanced-chair-rising test and the isometric maximum knee extension force in patients undergoing total knee replacements were studied. The intraclass correlation coefficient was calculated and a Bland-Altman analysis performed. RESULTS The weight-balanced-chair-rising test showed a symmetry at baseline = 0.77, 5 ± 1 days after surgery (t1) = 0.50, 9 ± 1 days (t2) = 0.59 and (t3) = 0.80. All performance tests showed high intraclass correlation coefficients (ICC = 0.81-0.99). The 10-m walk test, stair climbing test, and the timed-up-and-go test showed high agreement in the Bland-Altman analysis. The Bland-Altman analysis for the weight-balanced-chair-rising test and isometric knee extension force indicated high agreement at 5 and 9 days postoperatively, but the relative measurement error increased pre- and 10 weeks postoperatively. CONCLUSION In conclusion, symmetry, as an important outcome after TKA, is a reliable and rather unique item that should unquestionably be added to established measurements like walking tests or survey-based function assessment. The implementation of standardized performance-based measures to assess physical function in rehabilitation procedures will help to improve the more objectively based assessment of different rehabilitation protocols. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Robert Prill
- Department of Orthopedics and Traumatology, Centre of Joint Replacement West Brandenburg, Brandenburg Medical School Theodor Fontane, Hochstraße 29, 14770, Brandenburg, Germany.
| | - Roland Becker
- Department of Orthopedics and Traumatology, Centre of Joint Replacement West Brandenburg, Brandenburg Medical School Theodor Fontane, Hochstraße 29, 14770, Brandenburg, Germany
| | - Robert Schulz
- Berlin Institute of Health Quest Center, Berlin, Germany
| | - Sven Michel
- Brandenburg University of Technology-CS, Senftenberg, Germany
| | - Hagen Hommel
- Department of Orthopedics and Traumatology, Centre of Joint Replacement West Brandenburg, Brandenburg Medical School Theodor Fontane, Hochstraße 29, 14770, Brandenburg, Germany
- District Hospital Märkisch Oderland GmbH, Wriezen, Germany
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Rinaldi VG, Prill R, Jahnke S, Zaffagnini S, Becker R. The influence of gluteal muscle strength deficits on dynamic knee valgus: a scoping review. J Exp Orthop 2022; 9:81. [PMID: 35976534 PMCID: PMC9385941 DOI: 10.1186/s40634-022-00513-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/13/2022] [Indexed: 11/10/2022] Open
Abstract
Anterior cruciate ligament (ACL) injuries are caused by both contact and non-contact injuries. However, it can be claimed that non-contact ones account approximately for 70% of all cases. Thus, several authors have emphasized the role of reduction of muscle strength as a modifiable risk factor referred to non-contact ACL injury, with the latter being targeted by specific training interventions.The present paper wants to review the available literature specifically on the relationship between dynamic knee valgus, gluteal muscles (GM) strength, apart from the potential correlation regarding ACL injury.After a research based on MEDLINE via PubMed, Google scholar, and Web of Science, a total of 29 articles were collected and thus included.Additionally, this review highlights the crucial role of gluteal muscles in maintaining a correct knee position in the coronal plane during different exercises, namely walking, running, jumping and landing.
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Affiliation(s)
- Vito Gaetano Rinaldi
- II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, 40136, Bologna, Italy.
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg, Germany.,Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770, Brandenburg, Germany
| | - Sonja Jahnke
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg, Germany
| | - Stefano Zaffagnini
- II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, 40136, Bologna, Italy.,DIBINEM, University of Bologna, Bologna, Italy
| | - Roland Becker
- Medical School Theodor Fontane, 14770, Brandenburg, Germany.,Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg, Germany.,Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14770, Brandenburg, Germany
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Abstract
OBJECTIVES Transparent reporting of clinical trials is essential to assess the risk of bias and translate research findings into clinical practice. While existing studies have shown that deficiencies are common, detailed empirical and field-specific data are scarce. Therefore, this study aimed to examine current clinical trial reporting and transparent research practices in sports medicine and orthopaedics. SETTING Exploratory meta-research study on reporting quality and transparent research practices in orthopaedics and sports medicine clinical trials. PARTICIPANTS The sample included clinical trials published in the top 25% of sports medicine and orthopaedics journals over 9 months. PRIMARY AND SECONDARY OUTCOME MEASURES Two independent reviewers assessed pre-registration, open data and criteria related to scientific rigour, like randomisation, blinding, and sample size calculations, as well as the study sample, and data analysis. RESULTS The sample included 163 clinical trials from 27 journals. While the majority of trials mentioned rigour criteria, essential details were often missing. Sixty per cent (95% confidence interval (CI) 53% to 68%) of trials reported sample size calculations, but only 32% (95% CI 25% to 39%) justified the expected effect size. Few trials indicated the blinding status of all main stakeholders (4%; 95% CI 1% to 7%). Only 18% (95% CI 12% to 24%) included information on randomisation type, method and concealed allocation. Most trials reported participants' sex/gender (95%; 95% CI 92% to 98%) and information on inclusion and exclusion criteria (78%; 95% CI 72% to 84%). Only 20% (95% CI 14% to 26%) of trials were pre-registered. No trials deposited data in open repositories. CONCLUSIONS These results will aid the sports medicine and orthopaedics community in developing tailored interventions to improve reporting. While authors typically mention blinding, randomisation and other factors, essential details are often missing. Greater acceptance of open science practices, like pre-registration and open data, is needed. As these practices have been widely encouraged, we discuss systemic interventions that may improve clinical trial reporting.
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Affiliation(s)
- Robert Schulz
- BIH QUEST Center for Responsible Research, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of Sport and Health Sciences, University of Potsdam, Potsdam, Brandenburg, Germany
| | - Georg Langen
- Department of Strength, Power and Tactical Sports, Institute for Applied Training Science, Leipzig, Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, Brandenburg Medical School Theodor Fontane, Neuruppin, Brandenburg, Germany
| | - Michael Cassel
- Department of Sport and Health Sciences, University of Potsdam, Potsdam, Brandenburg, Germany
| | - Tracey L Weissgerber
- BIH QUEST Center for Responsible Research, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
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Andrä K, Prill R, Kayaalp E, Irlenbusch L, Liesaus E, Trommer T, Ullmann P, Becker R. Increase in cartilage degeneration in all knee compartments after failed ACL reconstruction at 4 years of follow-up. J Orthop Traumatol 2021; 22:54. [PMID: 34914026 PMCID: PMC8677851 DOI: 10.1186/s10195-021-00618-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 12/08/2021] [Indexed: 01/20/2023] Open
Abstract
Purpose Degeneration of the cartilage after anterior cruciate ligament reconstruction (ACL-R) is known, and further deterioration can be expected in patients with tunnel malplacement or partial meniscal resection. It was hypothesized that there is a significant increase in cartilage degeneration after failed ACL-R. Material and methods Isolated ACL revision surgery was performed in 154 patients at an interval of 46 ± 33 months (5–175 months) between primary and revision surgery. Cartilage status at the medial, lateral femorotibial, and patellofemoral compartments were assessed arthroscopically during primary and revision ACL-R in accordance with the Outerbridge classification. Tunnel placement, roof angle, and tibial slope was measured using anteroposterior and lateral radiographic views. Results Cartilage degeneration increased significantly in the medial femorotibial compartment, followed by the lateral and patellofemoral compartments. There was a correlation between both cartilage degeneration in the patellofemoral compartment (PFC) (rs = 0.28, p = 0.0012) and medial tibial plateau (Rs = 0.24, p = 0.003) in relation to the position of tibial tunnel in the frontal plane. Worsening of the cartilage status in the medial femorotibial compartment, either femoral or tibial, was correlated with the tibial aperture site in the lateral view (Rs = 0.28, p < 0.001). Cartilage degeneration in the lateral compartment of the knee, on both femoral or tibial side, was inversely correlated with the femoral roof angle (Rs = −0.1985, p = 0.02). Meniscal tears, either at the medial or lateral site or at both, were found in 93 patients (60%) during primary ACL-R and increased to 132 patients (86%) during revision ACL-R. Discussion Accelerated cartilage degeneration and high prevalence of meniscal lesions are seen in failed ACL-R. Tunnel placement showed significant impact on cartilage degeneration and may partially explain the increased risk of an inferior outcome when revision surgery is required after failed primary ACL-R. Level of evidence: Level IV—retrospective cohort study.
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Affiliation(s)
- Kathleen Andrä
- Center of Orthopaedics and Traumatology, University of Brandenburg, Medical School "Theodor Fontane", Hochstrasse 29, 14770, Brandenburg an der Havel, Germany.,SportsClinic Erfurt, Erfurt, Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University of Brandenburg, Medical School "Theodor Fontane", Hochstrasse 29, 14770, Brandenburg an der Havel, Germany
| | - Enes Kayaalp
- Department of Orthopedics and Traumatology, Istanbul Taksim Training and Research Hospital, Siraselviler Cad, Beyoglu, Istanbul, 34433, Turkey
| | | | | | | | | | - Roland Becker
- Center of Orthopaedics and Traumatology, University of Brandenburg, Medical School "Theodor Fontane", Hochstrasse 29, 14770, Brandenburg an der Havel, Germany.
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Prill R, Walter M, Królikowska A, Becker R. A Systematic Review of Diagnostic Accuracy and Clinical Applications of Wearable Movement Sensors for Knee Joint Rehabilitation. Sensors (Basel) 2021; 21:s21248221. [PMID: 34960315 PMCID: PMC8707010 DOI: 10.3390/s21248221] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 11/18/2022]
Abstract
In clinical practice, only a few reliable measurement instruments are available for monitoring knee joint rehabilitation. Advances to replace motion capturing with sensor data measurement have been made in the last years. Thus, a systematic review of the literature was performed, focusing on the implementation, diagnostic accuracy, and facilitators and barriers of integrating wearable sensor technology in clinical practices based on a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. For critical appraisal, the COSMIN Risk of Bias tool for reliability and measurement of error was used. PUBMED, Prospero, Cochrane database, and EMBASE were searched for eligible studies. Six studies reporting reliability aspects in using wearable sensor technology at any point after knee surgery in humans were included. All studies reported excellent results with high reliability coefficients, high limits of agreement, or a few detectable errors. They used different or partly inappropriate methods for estimating reliability or missed reporting essential information. Therefore, a moderate risk of bias must be considered. Further quality criterion studies in clinical settings are needed to synthesize the evidence for providing transparent recommendations for the clinical use of wearable movement sensors in knee joint rehabilitation.
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Affiliation(s)
- Robert Prill
- Center of Orthopaedics and Traumatology, Brandenburg Medical School, University Hospital Brandenburg/Havel, 14770 Brandenburg an der Havel, Germany;
- Correspondence:
| | - Marina Walter
- Hasso-Plattner-Institut, University of Potsdam, 14469 Potsdam, Germany;
| | - Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, 50-367 Wrocław, Poland;
| | - Roland Becker
- Center of Orthopaedics and Traumatology, Brandenburg Medical School, University Hospital Brandenburg/Havel, 14770 Brandenburg an der Havel, Germany;
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Prill R, Karlsson J, Ayeni OR, Becker R. Author guidelines for conducting systematic reviews and meta-analyses. Knee Surg Sports Traumatol Arthrosc 2021; 29:2739-2744. [PMID: 34181055 DOI: 10.1007/s00167-021-06631-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/08/2021] [Indexed: 11/24/2022]
Abstract
This article is a guidance how to write systematic reviews (SR's) and meta-analyses (MA) in orthopaedics and which aspects to focus on for transparency, systematicity and readability. Both SR and MA summarise and synthesise the best evidence available on a specific topic. This requires a systematic, structured and transparent process of analysis. The title should be concise, indicate type of review and ideally report the most important finding. Next, the structured abstract (no more than 350 words) should also raise key points and report the overall level of evidence. A relevant clinical question must be defined before the literature search is started. Methodological details such as databases searched, the exact search strategy (including time frame), inclusion/exclusion criteria, method of literature appraisal and statistical analysis must be described briefly. The primary and secondary outcomes should be mentioned. SR's be pre-registered before data extraction, to ensure transparency and the reduction of risk of bias. If registered, registration number should be stated in the abstract and the funding sources. A clear summary of the findings is important including the number of identified studies (depicted in a flowchart) and for meta-analyses a forest plot. The results of the literature appraisal and statistical analyses should be reported precisely. Subsequently, a general interpretation of findings and their significance and relevance to clinical practice should be provided. Clinical implications from the analysis should be drawn carefully and further research questions should be addressed. Finally, a conclusion, based solely on the results of the study is a necessity. Up to ten keywords are requested representing the main content of the article. Most applicable keywords should facilitate finding the manuscript in the databases and therefor considered carefully.
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Affiliation(s)
- Robert Prill
- Department of Orthopaedics and Traumatology, Brandenburg Medical School Theodor Fontane, Hochstrasse 29, 14770, Brandenburg, Germany.
| | - Jon Karlsson
- Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Olufemi R Ayeni
- Division of Orthopaedic Surgery, McMaster University, Hamilton, ON, Canada
| | - Roland Becker
- Department of Orthopaedics and Traumatology, Brandenburg Medical School Theodor Fontane, Hochstrasse 29, 14770, Brandenburg, Germany
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Andrä K, Kayaalp E, Prill R, Irlenbusch L, Liesaus E, Trommer T, Ullmann P, Becker R. Joint effusion, anteroposterior stability, muscle strength and degree of patellofemoral osteoarthritis significantly impact outcome following revision ACL reconstruction. J Exp Orthop 2021; 8:70. [PMID: 34436684 PMCID: PMC8390615 DOI: 10.1186/s40634-021-00370-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 07/12/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Effusion, impaired muscle function and knee instability are considered as some of the most important factors effecting outcome following anterior cruciate ligament reconstruction (ACL-R) but the impact on revision ACL-R remains unclear. It was hypothesized that these factors will significantly worsen clinical outcome following revision ACL-R. METHODS Seventy knees (13 female and 57 male) were followed retrospectively after revision ACL-R at a mean follow-up of 47.8 ± 20.7 months. Clinical examination was based on the International Knee Documentation Evaluation Form-2000 (IKDC), Tegner activity scale. Instrumented measurement of anterior tibial translation was performed using the Rolimeter® (DJO Global, Freiburg, Germany). Bilateral circumference of the thigh was measured 10 and 20 cm proximal to the medial joint space. Cartilage was assessed according to Outerbridge classification during both primary and revision ACL-R. RESULTS Tegner activity scale decreased significantly from 7.8 ± 1.4 points at primary ACL-R to 7 ± 1.8 points at revision ACL-R, and 5.8 ± 1.7 points at the time of follow up (p < 0.001). Joint effusion (r = - 0.47, p < 0.01) and side to side differences in single leg hop test (r = - 0.48, p < 0.1) significantly correlated with inferior outcome. Cartilage lesions were found in 67% of the patients at the time of revision ACL-R compared to 38% at the time of primary ACL-R. According to the IKDC classification A was graded in three patients (4.3%), B in 35 (50%), C in 29 (41.4%) and D in three (4.3%). Joint effusion was measured in 35% of patients at the time of follow-up. Degeneration at the patellofemoral compartment of > grad 2 was responsible for IKDC grade C and D (p = 0.035). Instrumented anteroposterior site-to-site difference of ≥3 mm showed significant impact on clinical outcome (p < 0.019). CONCLUSION The study has shown that chronic effusion, quadriceps dysfunction, cartilage lesions especially at the patellofemoral compartment and side to side difference in anteroposterior stability significantly influences patient outcome after revision ACL-R. These factors require special attention when predicting patient's outcome. LEVEL OF EVIDENCE Level-IV, case-controlled study.
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Affiliation(s)
- Kathleen Andrä
- Center of Orthopaedics and Traumatology, University of Brandenburg, Medical School "Theodor Fontane", Hochstrasse 29, 14770, Brandenburg an der Havel, Germany.,Sports Clinic Erfurt, Erfurt, Germany
| | - Enes Kayaalp
- Department of Orthopedics and Traumatology, Istanbul Taksim Training and Research Hospital, Siraselviler Cad. 34433 Beyoglu, Istanbul, Turkey
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University of Brandenburg, Medical School "Theodor Fontane", Hochstrasse 29, 14770, Brandenburg an der Havel, Germany
| | | | | | | | | | - Roland Becker
- Center of Orthopaedics and Traumatology, University of Brandenburg, Medical School "Theodor Fontane", Hochstrasse 29, 14770, Brandenburg an der Havel, Germany.
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Mühlensiepen F, Kurkowski S, Krusche M, Mucke J, Prill R, Heinze M, Welcker M, Schulze-Koops H, Vuillerme N, Schett G, Knitza J. Digital Health Transition in Rheumatology: A Qualitative Study. Int J Environ Res Public Health 2021; 18:ijerph18052636. [PMID: 33807952 PMCID: PMC7967307 DOI: 10.3390/ijerph18052636] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/27/2021] [Accepted: 03/02/2021] [Indexed: 12/12/2022]
Abstract
The global COVID-19 pandemic has led to drastic changes in the management of patients with rheumatic diseases. Due to the imminent risk of infection, monitoring intervals of rheumatic patients have prolonged. The aim of this study is to present insights from patients, rheumatologists, and digital product developers on the ongoing digital health transition in rheumatology. A qualitative and participatory semi-structured fishbowl approach was conducted to gain detailed insights from a total of 476 participants. The main findings show that digital health and remote care are generally welcomed by the participants. Five key themes emerged from the qualitative content analysis: (1) digital rheumatology use cases, (2) user descriptions, (3) adaptation to different environments of rheumatology care, and (4) potentials of and (5) barriers to digital rheumatology implementation. Codes were scaled by positive and negative ratings as well as on micro, meso, and macro levels. A main recommendation resulting from the insights is that both patients and rheumatologists need more information and education to successfully implement digital health tools into clinical routine.
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Affiliation(s)
- Felix Mühlensiepen
- Center for Health Services Research, Brandenburg Medical School Theodor Fontane, 15562 Rüdersdorf, Germany;
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14476 Potsdam, Germany;
- Correspondence:
| | - Sandra Kurkowski
- Department of Palliative Medicine, CCC Erlangen-EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany;
| | - Martin Krusche
- Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany;
| | - Johanna Mucke
- Policlinic and Hiller Research Unit for Rheumatology, Heinrich-Heine-University, 40225 Duesseldorf, Germany;
| | - Robert Prill
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 14476 Potsdam, Germany;
- Department of Orthopaedics and Trauma Surgery, Brandenburg Medical School Theodor Fontane, Municipal Clinic Brandenburg, 14770 Brandenburg, Germany
| | - Martin Heinze
- Center for Health Services Research, Brandenburg Medical School Theodor Fontane, 15562 Rüdersdorf, Germany;
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Immanuel Klinik Rüdersdorf, 15562 Rüdersdorf, Germany
| | - Martin Welcker
- Medizinisches Versorgungszentrum für Rheumatologie Dr. M. Welcker GmbH, 82152 Planegg, Germany;
| | - Hendrik Schulze-Koops
- Division of Rheumatology and Clinical Immunology, Department of Medicine IV, Ludwig-Maximilians-Universität München, 80336 Munich, Germany;
| | - Nicolas Vuillerme
- AGEIS, Faculty of Medicine, Université Grenoble Alpes, 38706 Grenoble, France; (N.V.); (J.K.)
- Institut Universitaire de France, 75006 Paris, France
- LabCom Telecom4Health, Université Grenoble Alpes & Orange Labs, 38400 Grenoble, France
| | - Georg Schett
- Department of Internal Medicine 3—Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany;
- Deutsches Zentrum für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Johannes Knitza
- AGEIS, Faculty of Medicine, Université Grenoble Alpes, 38706 Grenoble, France; (N.V.); (J.K.)
- Department of Internal Medicine 3—Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany;
- Deutsches Zentrum für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany
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Prill R, Singh JA, Seeber GH, Nielsen SM, Goodman S, Michel S, Kopkow C, Schulz R, Choong P, Hommel H. Patient, physiotherapist and surgeon endorsement of the core domain set for total hip and total knee replacement in Germany: a study protocol for an OMERACT initiative. BMJ Open 2020; 10:e035207. [PMID: 32595152 PMCID: PMC7322286 DOI: 10.1136/bmjopen-2019-035207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION There is a lack of harmonising measures for clinical trials on total joint replacement (TJR) that would allow for results from TJR studies to be compared or pooled. The Outcome Measures in Rheumatology (OMERACT) TJR core domain set is already endorsed among patients and physicians in the USA and Australia. Physiotherapists use different types of measurements compared to orthopaedic surgeons while both make substantial contributions to research in the field of TJR. To achieve consensus on core measurements sets, patients, physiotherapists and orthopaedic surgeons need to achieve consensus on the core domains for TJR trials. METHODS AND ANALYSIS For this multistage study, first, the OMERACT TJR core domain set survey will be translated to German and validated according to WHO guidelines. Next, the TJR core domain set will be considered for endorsement in different German stakeholder groups including patients, physiotherapists and orthopaedic surgeons. ETHICS AND DISSEMINATION Ethical approval for this protocol was given by the ethics committee of the Brandenburg University of Technology Cottbus-Senftenberg (BTU-CS, EK 2019-2). This article is based on the protocol version 2.5 from 6 May 2020. Anonymous data will be presented only. We will publish the results in peer-reviewed publications and at international conferences. TRIAL REGISTRATION NUMBER German Clinical Trials Registry (DRKS00016015).
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Affiliation(s)
- Robert Prill
- Therapy Sciences, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Jasvinder A Singh
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Medicine Service, Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA
| | - Gesine H Seeber
- University Hospital of Orthopedics and Trauma Surgery Pius-Hospital, Medical Campus University Oldenburg, Oldenburg, Germany
| | - Sabrina Mai Nielsen
- Musculoskeletal Statistics Unit, The Parker Institute, Frederiksberg, Denmark
| | - Susan Goodman
- Integrative Rheumatology and Orthopedics Center of Excellence, Weill Cornell Medicine, Hospital for Special Surgery, New York, New York, USA
| | - Sven Michel
- Therapy Sciences, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Christian Kopkow
- Therapy Sciences, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Robert Schulz
- Therapy Sciences, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Peter Choong
- Department of Surgery, St. Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
| | - Hagen Hommel
- Klinik für Orthopädie, Sportmedizin und Rehabilitation, Krankenhaus Markisch-Oderland GmbH, Wriezen, Germany
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Prill R, Schulz R, Michel S. Tissue flossing: a new short-term compression therapy for reducing exercise-induced delayed-onset muscle soreness. A randomized, controlled and double-blind pilot crossover trial. J Sports Med Phys Fitness 2019; 59:861-867. [DOI: 10.23736/s0022-4707.18.08701-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Prill R, Michel S, Schulz R, Coriolano HJA. Body Composition and Strength Parameters in Elite Judo Athletes 5 Years after Anterior Cruciate Ligament Reconstruction. Int J Sports Med 2018; 40:38-42. [PMID: 30481831 DOI: 10.1055/a-0787-1420] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The purpose of this study was to investigate if there are still deficits in muscle mass or strength capabilities in elite judo athletes with a history of anterior cruciate ligament reconstruction (ACLR) after their return to the sport. Therefore, bioimpedance analysis, 3D-laser thigh circumference measurement and isokinetic dynamometry in a closed kinetic chain were used. The side-to-side differences were investigated in a group of judo athletes 5 years after ACLR (n=17) and compared with a group of healthy judo athletes (n=27). Neither thigh circumferences, nor muscle masses of the lower extremities differed in formerly injured judo athletes compared to healthy judo athletes. In contrast, isokinetic strength testing showed a significantly larger side-to-side difference of peak muscle force in formerly injured judo athletes (p=0.021). They provided significantly lower peak forces with the formerly injured leg than with the non-injured leg (p<0.001). The authors conclude that strength capabilities, but not body composition, remains altered in recovered judo athletes in mean 5 years after ACLR and definitely after their return to sports. This indicates that the focus of rehabilitation protocols and return to sports assessments should focus more on maximum strength capabilities.
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Affiliation(s)
- Robert Prill
- Brandenburgische Technische Universität Cottbus-Senftenberg Campus Senftenberg, 4 Social Work, Health and Music, Senftenberg, Germany
| | - Sven Michel
- Brandenburgische Technische Universität Cottbus-Senftenberg Campus Senftenberg, 4 Social Work, Health and Music, Senftenberg, Germany
| | - Robert Schulz
- Brandenburgische Technische Universität Cottbus-Senftenberg Campus Senftenberg, 4 Social Work, Health and Music, Senftenberg, Germany
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Prill R, Kirschner J, Michel S, Schulz R, Hommel H. Study Protocol of a Multi-Stage Randomised Controlled Study for the Assessment of Postoperative Therapeutic Procedures after Total Knee Arthroplasty. International Journal of Physiotherapy 2018. [DOI: 10.15621/ijphy/2018/v5i1/167194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Shendell DG, Prill R, Fisk WJ, Apte MG, Blake D, Faulkner D. Associations between classroom CO2 concentrations and student attendance in Washington and Idaho. Indoor Air 2004; 14:333-341. [PMID: 15330793 DOI: 10.1111/j.1600-0668.2004.00251.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
UNLABELLED Student attendance in American public schools is a critical factor in securing limited operational funding. Student and teacher attendance influence academic performance. Limited data exist on indoor air and environmental quality (IEQ) in schools, and how IEQ affects attendance, health, or performance. This study explored the association of student absence with measures of indoor minus outdoor carbon dioxide concentration (dCO(2)). Absence and dCO(2) data were collected from 409 traditional and 25 portable classrooms from 22 schools located in six school districts in the states of Washington and Idaho. Study classrooms had individual heating, ventilation, and air conditioning (HVAC) systems, except two classrooms without mechanical ventilation. Classroom attributes, student attendance and school-level ethnicity, gender, and socioeconomic status (SES) were included in multivariate modeling. Forty-five percent of classrooms studied had short-term indoor CO(2) concentrations above 1000 p.p.m. A 1000 p.p.m. increase in dCO(2) was associated (P < 0.05) with a 0.5-0.9% decrease in annual average daily attendance (ADA), corresponding to a relative 10-20% increase in student absence. Annual ADA was 2% higher (P < 0.0001) in traditional than in portable classrooms. PRACTICAL IMPLICATIONS This study provides motivation for larger school studies to investigate associations of student attendance, and occupant health and student performance, with longer term indoor minus outdoor CO(2) concentrations and more accurately measured ventilation rates. If our findings are confirmed, improving classroom ventilation should be considered a practical means of reducing student absence. Adequate or enhanced ventilation may be achieved, for example, with educational training programs for teachers and facilities staff on ventilation system operation and maintenance. Also, technological interventions such as improved automated control systems could provide continuous ventilation during occupied times, regardless of occupant thermal comfort demands.
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Affiliation(s)
- D G Shendell
- Lawrence Berkeley National Laboratory, Environmental Energy Technologies Division, Indoor Environment Department, Berkeley, CA, USA
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Leonidas DD, Boix E, Prill R, Suzuki M, Turton R, Minson K, Swaminathan GJ, Youle RJ, Acharya KR. Mapping the ribonucleolytic active site of eosinophil-derived neurotoxin (EDN). High resolution crystal structures of EDN complexes with adenylic nucleotide inhibitors. J Biol Chem 2001; 276:15009-17. [PMID: 11154698 DOI: 10.1074/jbc.m010585200] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Eosinophil-derived neurotoxin (EDN), a basic ribonuclease found in the large specific granules of eosinophils, belongs to the pancreatic RNase A family. Although its physiological function is still unclear, it has been shown that EDN is a neurotoxin capable of inducing the Gordon phenomenon in rabbits. EDN is also a potent helminthotoxin and can mediate antiviral activity of eosinophils against isolated virions of the respiratory syncytial virus. EDN is a catalytically efficient RNase sharing similar substrate specificity with pancreatic RNase A with its ribonucleolytic activity being absolutely essential for its neurotoxic, helminthotoxic, and antiviral activities. The crystal structure of recombinant human EDN in the unliganded form has been determined previously (Mosimann, S. C., Newton, D. L., Youle, R. J., and James, M. N. G. (1996) J. Mol. Biol. 260, 540-552). We have now determined high resolution (1.8 A) crystal structures for EDN in complex with adenosine-3',5'-diphosphate (3',5'-ADP), adenosine-2',5'-di-phosphate (2',5'-ADP), adenosine-5'-diphosphate (5'-ADP) as well as for a native structure in the presence of sulfate refined at 1.6 A. The inhibition constant of these mononucleotides for EDN has been determined. The structures present the first detailed picture of differences between EDN and RNase A in substrate recognition at the ribonucleolytic active site. They also provide a starting point for the design of tight-binding inhibitors, which may be used to restrain the RNase activity of EDN.
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Affiliation(s)
- D D Leonidas
- Department of Biology and Biochemistry, University of Bath, Claverton Down, Bath BA2 7AY, United Kingdom
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Christiansen SP, Sandnas A, Prill R, Youle RJ, McLoon LK. Acute effects of the skeletal muscle-specific immunotoxin ricin-mAb 35 on extraocular muscles of rabbits. Invest Ophthalmol Vis Sci 2000; 41:3402-9. [PMID: 11006231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
PURPOSE To determine the acute histologic and ultrastructural effects of a recently developed muscle-specific immunotoxin, ricin-mAb 35. METHODS Graduated doses of ricin-mAb 35, composed of ricin conjugated to a monoclonal antibody against the nicotinic acetylcholine receptor of skeletal muscle, were injected into one superior rectus muscle in rabbits. After 3, 7, and 14 days, both superior rectus muscles were removed and prepared for electron microscopy and histologic examination, by using a number of immunohistochemical markers to identify inflammatory cell infiltration, muscle fiber loss, and muscle regeneration. RESULTS Myotoxicity of the ricin-mAb 35 was focal and dose related. At the highest dose tested, there was substantial inflammatory cell infiltrate by 3 days, which largely disappeared by 7 days. Significant muscle loss was apparent by 7 days after ricin-mAb 35 treatment. Both the inflammatory reaction and muscle fiber loss were confined to the immediate injection site. Surrounding muscle appeared to be normal. At 14 days after treatment, early signs of muscle regeneration were evident within the tissue sections. No evidence of orbital or systemic toxicity was seen in any animal. CONCLUSIONS Direct injection of ricin-mAb 35 into the extraocular muscles of rabbits results in a dose-related focal injury to the muscles, with a self-limited inflammatory component and significant muscle fiber loss. This novel immunotoxin may be useful in the treatment of strabismus if chronic studies show a sustained histologic and electrophysiologic effect.
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Affiliation(s)
- S P Christiansen
- Department of Ophthalmology, University of Minnesota, Minneapolis 55455, USA
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