Prescription of individual therapeutic exercises via smartphone app for patients suffering from non-specific back pain : A qualitative feasibility and quantitative pilot study.

Background: The purpose of this qualitative study was the assessment of the feasibility and acceptance of orthopedists prescribing individualized therapeutic exercises via a smartphone app to patients suffering from non-specific back pain.

Methods: A total of 27 patients (mean age 44.8 ± 13.

Analysis of Running-Related Injuries: The Vienna Study.

Background: This study aimed to provide an extensive and up-to-date analysis of running-related injuries (RRI) and analyze a broad range of contributing factors for a large heterogeneous and non-selected running population from Central Europe.

Methods: Anthropometric, training, footwear, anatomic malalignment, and injury data from 196 injured runners were assessed case-controlled and retrospectively. Univariate and multivariate regression models were developed to identify associated factors for specific injury locations and diagnoses.

Treatment of Full-Thickness Chondral Defects With Hyalograft C in the Knee: Long-term Results.

Background: Matrix-associated autologous chondrocyte transplantation (MACT) has become an established articular cartilage repair technique. It provides good short-term and midterm results; however, long-term results are lacking.

Purpose: To prospectively assess the clinical outcome after MACT in the knee to report long-term results.

Uptake studies with chondrotropic 99mTc-chondroitin sulfate in articular cartilage. Implications for imaging osteoarthritis in the knee.

Chondroitin sulfate (CS) is an endogenous component of extracellular matrix in the cartilage and can be valuable for imaging of cartilage degeneration after radiolabeling. Data monitoring the uptake of (99m)TcCS by human cartilage are rare. Radiolabeling was performed by (99m)TcO4(-)/tin method at pH5.

Surgical management of osteoarthritis.

The last few years have witnessed significant advancements in arthroplasty. The procedure is mainly used to treat osteoarthritis of the hip and knee joint. Other joints such as the shoulder or ankle are also being successfully replaced by arthroplasty.

Effect of pulsed electromagnetic fields on the bioactivity of human osteoarthritic chondrocytes.

Low-frequency pulsed electromagnetic fields (PEMFs) are used for the treatment of human osteoarthritic cells in vivo without knowledge of underling principles. The authors evaluated the effect of PEMFs on human chondrocytes of the osteoarthritic knee in vitro. Biopsies of the cut femoral condyles after total knee arthroplasty were kept in a standard cell culture medium consisting of Dulbecco's modified Eagle's medium: nutrient mixture F-12, 10% fetal calf serum, PenStrept (Mediatech, Inc, Manassas, Virginia), and ascorbic acid for 4 days and randomly split into an exposed group (PEMF for 4 hours daily for 4 days at 75 Hz and 1.

Does increased health care spending afford better health care outcomes? Evidence from Austrian health care expenditure since the implementation of DRGs.

Aims: While it is commonly accepted that health care costs have been rising to unprecedented levels, the question remains whether the increased expenditure actually affords increased health outcomes. It was the objective of this study to search for associations between health care spending and health care outcome, after adjusting for potential confounding variables, using aggregate data collected since the introduction of diagnosis-related groups (DRG) into Austrian health care financing in 1997.

Methods: Two parameters of health care outcome, mortality and years of life lost (YLL), were regressed on direct and indirect measures of health care spending.

Critical-size defect induces unicompartmental osteoarthritis in a stable ovine knee.

Animal models simulating osteoarthritis are frequently associated with irreversible changes in biomechanics. Although these models successfully induce osteoarthritis, results of experimental repair procedures are impaired by biomechanical problems. The aim of this study was to define the critical size of a chondral lesion to induce unicompartmental osteoarthritis in a stable joint.

Burden of musculoskeletal disease and its determination by urbanicity, socioeconomic status, age, and sex: Results from 14,507 subjects.

Objective: The availability of reliable estimates of the burden of musculoskeletal disease is of considerable importance for policymakers.

Methods: This study uses data from the 14,507 participants of the European Health Interview Survey conducted in Austria in 2006/2007 to calculate estimates of the prevalence of osteoarthritis, spinal conditions, and osteoporosis in a population representative of other European Union or Organisation for Economic Co-operation and Development member states. Urbanicity, socioeconomic status, and age and sex were included as determinants of musculoskeletal disease.

The prevalence and effect of publication bias in orthopaedic meta-analyses.

Background: Meta-analyses of randomized, controlled trials are considered the highest level-of-evidence, thus strongest source of information. However, questions concerning the validity of meta-analyses in orthopaedic surgery emerged recently. Among the most common sources for errors is publication bias.

Modeling the "minimally invasive surgery effect" in total joint replacement.

Introduction: A beneficial effect of minimally invasive surgery (MIS) in total joint replacement has been postulated, but to date it still remains to be proven. This study aimed at assessing what the common effects of MIS are in all clinical trials/studies.

Methods: Randomized controlled trials of MIS total joint replacement were searched online in Medline, EMBASE, CINAHL, and the Cochrane Library.

Economic evaluation of NSAID and radiation to prevent heterotopic ossification after hip surgery.

Introduction: Heterotopic ossification (HO) is a known complication in hip surgery, but there is still uncertainty whether to use non-steroidal anti-inflammatory drugs (NSAID) or radiation in its prevention. While the literature focuses almost exclusively on (as it turns out the lacking) difference in effectiveness, one important difference that has been widely unacknowledged thus far is cost-effectiveness.

Method: We systematically reviewed the literature to extract evidence-based estimates of treatment effectiveness, complications, and associated costs.

Matrix-Associated and Autologous Chondrocyte Transplantation in the Ankle: Clinical and MRI Follow-up after 2 to 11 Years.

Background: New matrix-associated autologous chondrocyte transplantation (MACT) techniques may facilitate the treatment of chondral defects in talar cartilage and provide good clinical outcome in the long term. The aim of this prospective case series was to monitor the clinical outcome after autologous chondrocyte transplantation (ACT) and MACT in the ankle to gain data on the mid-term efficacy of the procedure.

Methods: Seventeen cases of talar cartilage defects were assessed with the American Orthopaedic Foot and Ankle Score (AOFAS), a modified Cincinnati score, and a subjective ankle-hindfoot score (AHS) at a mean of 61 (24-135) months after surgery.

An in vitro model of biomaterial-augmented microfracture including chondrocyte-progenitor cell interaction.

Background: Biomaterials, acting as scaffolds for cell migration and differentiation, may be used to improve outcomes after microfracture. Three mechanisms determine the success of such procedures and are tested herein: the general capacity of adult femoral mesenchymal progenitor cells (MPC) to differentiate into cartilage, their capacity to do so in a biomaterial, and finally potential interactions between MPC and autologous chondrocytes.

Methods: Human adult chondrocytes and MPC were obtained with informed consent and cultured individually or in co-culture on a collagenous biomaterial.

Delayed gadolinium-enhanced MRI of cartilage in the ankle at 3 T: feasibility and preliminary results after matrix-associated autologous chondrocyte implantation.

Purpose: To demonstrate the feasibility of delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) in the ankle at 3 T and to obtain preliminary data on matrix associated autologous chondrocyte (MACI) repair tissue.

Materials And Methods: A 3D dual flip angle sequence was used with an eight-channel multipurpose coil at 3 T to obtain T1 maps both pre- and postintravenous contrast agent (Magnevist, 0.2 mM/kg).

Treatment of full-thickness chondral defects with hyalograft C in the knee: a prospective clinical case series with 2 to 7 years' follow-up.

Background: Tissue engineering has become available for cartilage repair in clinical practice.

Hypothesis: The treatment of full-thickness chondral defects in the knee with a hyaluronan-based scaffold seeded with autologous chondrocytes provides stable improvement of clinical outcome up to 7 years.

Study Design: Case series; Level of evidence, 4.

Effectiveness of pulsed electromagnetic field therapy in the management of osteoarthritis of the knee: a meta-analysis of randomized controlled trials.

Objective: To assess the effectiveness of pulsed electromagnetic fields compared with placebo in the management of osteoarthritis of the knee.

Data Sources: A systematic review of PubMed, EMBASE, and the Cochrane Controlled Trials Register.

Methods: Randomized, controlled trials reporting on the blinded comparison of pulsed electromagnetic fields with placebo were included.

The use of confidence intervals in reporting orthopaedic research findings.

Conflict between clinical importance and statistical significance is an important problem in medical research. Although clinical importance is best described by asking for the effect size or how much, statistical significance can only suggest whether there is any difference. One way to combine statistical significance and effect sizes is to report confidence intervals.

Initial results of in vivo high-resolution morphological and biochemical cartilage imaging of patients after matrix-associated autologous chondrocyte transplantation (MACT) of the ankle.

Objective: The aim of this study was to use morphological as well as biochemical (T2 and T2* relaxation times and diffusion-weighted imaging (DWI)) magnetic resonance imaging (MRI) for the evaluation of healthy cartilage and cartilage repair tissue after matrix-associated autologous chondrocyte transplantation (MACT) of the ankle joint.

Materials And Methods: Ten healthy volunteers (mean age, 32.4 years) and 12 patients who underwent MACT of the ankle joint (mean age, 32.

A systematic review of conflicting meta-analyses in orthopaedic surgery.

Meta-analyses are important evaluations in orthopaedic surgery, not only to create clinical guidelines, but also because their findings are included in public health and health policy decision making. However, with increasing numbers of meta-analyses, discordant and frankly conflicting conclusions have been reported. We searched for conflicting meta-analyses, ie, those arriving at different conclusions despite following the same research question, identified potential reasons for these differences, and assessed the statistical significance and clinical importance of differences.

Focused extracorporeal shock wave therapy in calcifying tendinitis of the shoulder: a meta-analysis.

Background: The objective of this study is to assess the effectiveness of extracorporeal shock wave therapy in the management of calcifying tendinitis of the shoulder. Furthermore, a dose-response relationship was sought as a secondary confirmation of effectiveness.

Hypothesis: Focused extracorporeal shock wave therapy has a high, dose-responsive effectiveness in the management of calcifying tendinitis of the shoulder.

MRI monitoring of cartilage repair in the knee: a review.

Various treatment options for deep cartilage defects are presently available. The efficacy of bone marrow stimulation with microfracture, of mosaicplasty and of various autologous chondrocyte implantation (ACI) techniques has been subject to numerous studies recently. Magnetic resonance imaging (MRI) has gained a major role in the assessment of cartilage repair.

Different behavior of meniscal cells in collagen II/I,III and Hyaff-11 scaffolds in vitro.

The purpose of this study was to evaluate the behavior of ovine meniscal cells seeded on biomaterials made from collagen and hyaluronan, respectively. Ovine meniscal cells were isolated from the medial menisci of stifle joints, expanded in monolayer culture, and seeded on scaffolds made of collagen type II and I/III and a hyaluronan derivative (Hyaff-11). The samples were cultured for 12 h and 7, 14, 21, and 28 days.

Cartilage T2 assessment at 3-T MR imaging: in vivo differentiation of normal hyaline cartilage from reparative tissue after two cartilage repair procedures--initial experience.

Purpose: To prospectively compare cartilage T2 values after microfracture therapy (MFX) and matrix-associated autologous chondrocyte transplantation (MACT) repair procedures.

Materials And Methods: The study had institutional review board approval by the ethics committee of the Medical University of Vienna; informed consent was obtained. Twenty patients who underwent MFX or MACT (10 in each group) were enrolled.