Autonomic dysreflexia: a possible trigger for the development of heterotopic ossifications after traumatic spinal cord injury? : A clinical longitudinal study.

PURPOSE: The aim of this study was to investigate the influence of the initial American Spinal Injury Association Impairment Scale (AIS) category and the conversion rate in acute traumatic tetraplegic patients on the development of heterotopic ossifications (HO). The second objective was to prove the hypothesis that tetraplegic patients with autonomic dysreflexia (AD) develop HO more often than patients without AD. METHODS: A retrospective analysis from 2002 to 2009 of 330 patients with spinal cord injuries was performed and led to the inclusion of 77 traumatic tetraplegic patients. Clinical data was reviewed to determine the appearance of HO (n = 8) and its possible coincidence with AD during urodynamics. Spearman's correlation coefficient was calculated to test the relationship between HO and initial AIS category or the change in AIS category within 6 weeks. A matched pair (age, neurological level of injury) analysis of two samples (n = 8 with/without appearance of HO; total n = 16) was performed. RESULTS: The appearance of HO was significantly correlated with an initial AIS A compared to incomplete tetraplegia at baseline (p < 0.017). The conversion of AIS A into incomplete tetraplegia was highly correlated with the incidence of HO (p < 0.003). AD showed a positive correlation with HO (r = 0.97, p = 0.001). CONCLUSIONS: An initial AIS A that converts early into an incomplete tetraplegia constitutes a risk factor for the development of HO. Additionally, AD constitutes an important trigger in the development of HO in acute traumatic tetraplegic patients.

[Five-year survival rate of the Allofit titanium press-fit cup]. / 5-Jahres-Ergebnisse der zementfreien Allofit(R)-Press-fit-Pfanne.

BACKGROUND: The Allofit titanium press-fit cup has become the best-selling cementless acetabular implant in Germany, with approximately 30,000 implants sold in 2007. However, only a limited number of scientific publications - mostly from the development centres in Austria - support this success on the market. METHODS: At our institution in 1999-2000, 174 total hip replacements were performed using the Allofit cementless press-fit cup. At a mean follow-up of 5.3 years (range 40-85 months), 154 patients were evaluated clinically and radiographically, representing a follow-up rate of 89%. RESULTS: The 5-year survival rate was 98.1% (95% CI: 95.8-100%), with revision for any reason as an end point. Three cups were revised (aseptic loosening with one, and two septic complications). The average Harris hip score was 89.1+/-13.7 in all unrevised patients. CONCLUSION: We confirm the excellent survival rates of the Allofit cup as reported by the development centres, supporting the ongoing use of the cup at our institution.

[No sports = no exercise?--sports, overweight and physical activity in the 50-70 age group in Baden-Württemberg]. / Sind Bewegungsmuffel auch Sportmuffel? Sport, Ubergewicht und körperliche Mobilität in der Gruppe der 50- bis 70-jährigen baden-württembergischen Bevölkerung.

Sporting activity is proven to decline with advancing age. But do older adults replace sporting activity with physical activity like walking and cycling for transportation purposes, and are people with a history of sporting activity more likely to integrate physical activity in their day-today lives? There is a proven negative correlation between sporting activity and overweight, a major risk factor for numerous diseases. The purpose of this study was to investigate correlations between walking/cycling for transportation and sporting activity/overweight, while controlling other variables. This representative study, which includes 50 to 70 year old people from Baden-Württemberg, is sponsored by the Landesstiftung Baden-Württemberg (N=2002). People who say they use a bicycle for transportation on a regular basis, and those who go for walks on a regular basis, are significantly more likely to engage in sports than people who do not go for walks or cycle regularly. The correlation applies after controlling sociodemographic and lifestyle relevant variables. With regard to the correlation between physical activity and overweight, the results show that older adults who go for walks regularly are more likely to be overweight than those who do not. In contrast, those who use a bicycle for transportation on a regular basis are significantly less likely to be overweight. Older adults who do not work out do not compensate for this by physical activity in their day-today lives, i.e., no work out = no physical activity. In recognition of the biological and medical role of sporting activity and exercise for preserving health, exercising and doing sports is of special importance especially for older adults.

[Total knee arthroplasty - GPs' views in Germany: a questionnaire-based study]. / Beurteilung des Verfahrens der Knieendoprothetik durch deutsche Hausärzte: Eine Fragebogenstudie.

To assess general knowledge and individual views of general practitioners (GPs) on total knee arthroplasty (TKA), we conducted a questionnaire-based survey involving 170 GPs in Germany. Eighty-one GPs returned the questionnaire. They treat a mean of 10.6+/-8.3 patients with TKA. General knowledge can be estimated as good. Compared with the data in the literature, GPs assessed the rate of satisfied patients as lower and the risk for revision surgery as higher. The mean risk of potential complications (infection, instability, persistent pain) in association with TKA was estimated correctly. Seventy-eight percent of GPs consider an allergic reaction to the implant or bone cement as problematic. The number of cases per year, personal experience with the surgeon, and - less important - local accessibility are important factors for GPs when recommending an operating centre to a patient.A broad spectrum of individual responses indicates the need to improve the information transfer between orthopaedic surgeons and referring GPs.

["Living an active life"--sports, exercise and health in middle-aged and older adults. An empirical database on physical activity, health behavior and lifestyle in the 50- to 70-year-old residential population of Baden-Wuerttemberg]. / "Ein aktives Leben leben"--Sport, Bewegung und Gesundheit im mittleren und höheren Erwachsenenalter. Konzeption, Datenerhebung und erste Ergebnisse eines repräsentativen Basis-Survey für die 50- bis 70-jährige baden-württembergische Wohnbevölkerung.

In a society with an aging population, the preventive healthcare importance of physical activity in middle-aged and older adults is growing. The purpose of the study "Living an active life - age and aging in Baden-Wuerttemberg" is to acquire generalisable data of practical relevance for the 50- to 70-year-old population of Baden-Wuerttemberg. The main themes of this study are sports, exercise, and health-related and lifestyle aspects--from both a current and a biographical perspective. Following conceptualization and a test run, the survey was conducted by means of a computer-assisted telephone interview (CATI) in the period from May to October 2006. 982 men and 1,020 women responded. The percentage of respondents with a high level of education was disproportionately high, as is frequently the case for telephone surveys. Due to the resultant bias, the data was weighted by age, gender and education on the basis of the German Microcensus 2004. In addition to serving as a health report on the middle-aged and older adult population, this basic survey generated representative data on physical/sporting activity among older people in Baden-Wuerttemberg, and can be used as a reliable basis for designing future preventive measures. First analyses show that people with higher educational levels and good health, and non-smokers, people with balanced diet and normal weight are more likely to do sporting activities.

[Total hip replacement--GPs' views in Germany. A questionnaire-based study]. / Beurteilung des Verfahrens Hüftendoprothetik durch deutsche Hausärzte. Eine Fragebogenstudie.

To assess the general knowledge and individual views of general practitioners (GPs) on total hip arthroplasty (THA), we performed a questionnaire-based survey involving 200 GPs in Germany.Ninety-four GPs returned the questionnaire. They had treated a mean of 37.7+/-38.6 patients (range 0-300) with THA. Their general knowledge can be estimated as good. They assessed the potential for complications in association with THA as higher than that reported in the literature. If the GPs had been exposed to more complications in their practices, they estimated a lower patient satisfaction rate 10 years after surgery and were less satisfied with the indications given by their operating colleagues.A broad spectrum of individual responses indicates the need to improve information transfer between orthopaedic surgeons and referring GPs.