AIM OF STUDY: To develop recommendations for appropriate diagnostic procedures and conservative treatment of knee osteoarthritis in outpatients. MATERIAL AND METHODS: Following a consensus conference and expert reviews basic recommendations were developed. RESULTS: While standardized radiographic assessment is mandatory, MRI investigation should be restricted to problems apart from osteoarthritis. Indications for physical therapy, bracing and pharmaco-treatment depend on the severity of the disease. Guidelines for intraarticular injections are presented. CONCLUSION: Effective treatment of knee osteoarthritis must be based on available recommendations and guidelines.

Ambulatory Care↗

PubMedDate not supplied

[The Pediatric Musculoskeletal Functional Health Questionnaire. A function assessment questionnaire for detection of illnesses of the locomotor system in children and adolescents--initial results of validating a German version].

AIM: It was the purpose of this investigation to create a German version of the Pediatric Musculoskeletal Functional Health Questionnaire and to test its reliability, practicability and acceptance in children and adolescents with musculoskeletal disorders. METHODS: In a first step, the Pediatric Musculoskeletal Functional Health Questionnaire was translated into the German language. Then 147 patients with musculoskeletal disorders or respectively, their parents were asked to fill in the questionnaire, in order to test the reliability, the internal consistency, the practicability, and the acceptance of this instrument. RESULTS: The test-retest reliability for the subscales was high, it ranged between r = 0.56 and 0.93. Concerning the internal consistency of items and subscales we found only moderate results. The acceptance of the Questionnaire was high in patients or, respectively, their parents with 92%. Furthermore, the instrument has shown to be practicable and economical. CONCLUSION: With the German version of the Pediatric Musculoskeletal Functional Health Questionnaire a multidimensional instrument is now available that reliably measures health status as well as therapeutic effects in children and adolescents with musculoskeletal disorders.

Adolescent↗

PubMedDate not supplied

[Reproducibility of radiological classification criteria of femur head necrosis].

AIM: To assess the reliability of commonly used radiographic features in osteonecrosis of the femoral head. METHOD: For staging of avascular necrosis of the femoral head two different classification systems, Ficat and ARCO, were applied. To measure the size of the necrotic lesions the combined necrotic angle of Kerboul was used. Radiographs of 49 patients with osteonecrosis of the femoral head were graded by two observers at two different time points. The Spearman's correlation coefficient was calculated for intra- and inter-observer reliability. RESULTS: We found good intra- (Spearman's correlation coefficient 0.81-0.87) and inter-observer reliability (0.71-0.74) for the Kerboul's angle. Reliability for the ARCO stage classification was acceptable for intra-observer but unacceptable for inter-observer agreement. The reproducibility of the Ficat staging system was unacceptable. CONCLUSION: The Kerboul angle is a reliable measurement to assess the severity of the osteonecrotic defects in femoral heads. The staging systems of Ficat and ARCO are not sufficiently reliable to assess the disease status of the hip alone.

Adult↗