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4. Patient Expectations about Communication in the Perioperative Setting of Elective Knee Surgery - a Questionnaire-based Cross-sectional Study.

Author

Walter SG, Naal F, Impellizzeri FM, Moser B, Schildberg FA, Drobny T, Preiss S, Salzmann GM, Walter SG, Naal F, Impellizzeri FM, Moser B, Schildberg FA, Drobny T, Preiss S, and Salzmann GM

Abstract

Background

Patient expectations are an issue which is attracting increased interest in outcome research for knee surgery procedures. So far, research into patient expectations has mainly focused on the procedure and postoperative functional improvements. The purpose of this study was to identify patient expectations in the perioperative setting.

Material and methods

This was a single-center prospective study. A 17-item questionnaire (ordinal answer scale) about patients' perioperative expectations was developed and completed by patients undergoing elective joint-preserving knee surgery. The study covered a period of 3 months and included all patients consecutively undergoing knee surgery. Subgroup analysis was performed for gender, age and type of insurance.

Results

111 consecutive patients completed the questionnaire on admission. Significant preferences for one answer option were found for 13 out of 17 items. Patients considered it "unimportant" whether or not the physician wore a white coat during the consultation and "very important" that the first medical consultation after the patient was discharged from hospital was with the surgeon who had performed their operation. A concise explanation of the surgical procedure using images, talking to the surgeon the day before surgery and immediately after surgery, having their wound personally inspected by the surgeon, and, finally, the availability of the surgeon by phone were regarded as "important". There were no differences in patient responses between the different subgroups.

Conclusion

Patients expect a high personal commitment and availability of the surgeon during the entire perioperative setting, starting from the first consultation and continuing during follow-up examinations.

Published
2020

5. Patient Expectations about Communication in the Perioperative Setting of Elective Knee Surgery - a Questionnaire-based Cross-sectional Study.

Author

Walter SG, Naal F, Impellizzeri FM, Moser B, Schildberg FA, Drobny T, Preiss S, Salzmann GM, Walter SG, Naal F, Impellizzeri FM, Moser B, Schildberg FA, Drobny T, Preiss S, and Salzmann GM

Abstract

Background

Patient expectations are an issue which is attracting increased interest in outcome research for knee surgery procedures. So far, research into patient expectations has mainly focused on the procedure and postoperative functional improvements. The purpose of this study was to identify patient expectations in the perioperative setting.

Material and methods

This was a single-center prospective study. A 17-item questionnaire (ordinal answer scale) about patients' perioperative expectations was developed and completed by patients undergoing elective joint-preserving knee surgery. The study covered a period of 3 months and included all patients consecutively undergoing knee surgery. Subgroup analysis was performed for gender, age and type of insurance.

Results

111 consecutive patients completed the questionnaire on admission. Significant preferences for one answer option were found for 13 out of 17 items. Patients considered it "unimportant" whether or not the physician wore a white coat during the consultation and "very important" that the first medical consultation after the patient was discharged from hospital was with the surgeon who had performed their operation. A concise explanation of the surgical procedure using images, talking to the surgeon the day before surgery and immediately after surgery, having their wound personally inspected by the surgeon, and, finally, the availability of the surgeon by phone were regarded as "important". There were no differences in patient responses between the different subgroups.

Conclusion

Patients expect a high personal commitment and availability of the surgeon during the entire perioperative setting, starting from the first consultation and continuing during follow-up examinations.

Published
2020

6. Chondrocyte Culture Parameters for Matrix-Assisted Autologous Chondrocyte Implantation Affect Catabolism and Inflammation in a Rabbit Model

Author

Sportbiologie, Sauerschnig M, Berninger MT, Kaltenhauser T, Plecko M, Wexel G, Schoenfelder M , Wienerroither V, Imhoff AB, Schoettle PB, Rosado Balmayor E, Salzmann GM, Sportbiologie, and Sauerschnig M, Berninger MT, Kaltenhauser T, Plecko M, Wexel G, Schoenfelder M , Wienerroither V, Imhoff AB, Schoettle PB, Rosado Balmayor E, Salzmann GM

Abstract

Cartilage defects represent an increasing pathology among active individuals that affects the ability to contribute to sports and daily life. Cell therapy, such as autologous chondrocyte implantation (ACI), is a widespread option to treat larger cartilage defects still lacking standardization of in vitro cell culture parameters. We hypothesize that mRNA expression of cytokines and proteases before and after ACI is influenced by in vitro parameters: cell-passage, cell-density and membrane-holding time. Knee joint articular chondrocytes, harvested from rabbits (n = 60), were cultured/processed under varying conditions: after three different cell-passages (P1, P3, and P5), cells were seeded on 3D collagen matrices (approximately 25mm3) at three different densities (2 x 10 5/matrix, 1 x 10 6/matrix, and 3 x 10 6/matrix) combined with two different membrane-holding times (5 h and two weeks) prior autologous transplantation. Those combinations resulted in 18 different in vivo experimental groups. Two defects/knee/animal were created in the trochlear groove (defect dimension: radius 4 mm x 2 mm). Four identical cell-seeded matrices (CSM) were assembled and grouped in two pairs: One pair giving pre-operative in vitro data (CSM-i), the other pair was implanted in vivo and harvested 12 weeks post-implantation (CSM-e). CSMs were analyzed for TNF-alpha, IL-1beta, MMP-1, and MMP-3 via qPCR. CSM-i showed higher expression of IL-1beta, MMP-1, and MMP-3 compared to CSM-e. TNF-alpha expression was higher in CSM-e. Linearity between CSM-i and CSM-e values was found, except for TNF-alpha. IL-1beta expression was higher in CSM-i at higher passage and longer membrane-holding time. IL-1beta expression decreased with prolonged membrane-holding time in CSM-e. For TNF-alpha, the reverse was true. Lower cell-passages and lower membrane-holding time resulted in stronger TNF-alpha expression. Prolonged membrane-holding time resulted in increased MMP levels among CSM-i and CSM-e. Cellular densi

Published
2018

26. Die simulierte ACT unter arthrotischen Bedingungen

Author

Salzmann, GM, Erggelet, J, Niemeyer, P, Schmal, H, Stoddart, M, Grad, S, Alini, M, Südkamp, NP, Salzmann, GM, Erggelet, J, Niemeyer, P, Schmal, H, Stoddart, M, Grad, S, Alini, M, and Südkamp, NP

Published
2012

28. Die simulierte ACT unter arthrotischen Bedingungen

Author

Salzmann, GM, Erggelet, J, Niemeyer, P, Schmal, H, Stoddart, M, Grad, S, Alini, M, Südkamp, NP, Salzmann, GM, Erggelet, J, Niemeyer, P, Schmal, H, Stoddart, M, Grad, S, Alini, M, and Südkamp, NP

Published
2012

42. The dependence of autologous chondrocyte transplantation on varying cellular passage, yield and culture duration

Author

Sportbiologie, Salzmann GM, Sauerschnig M, Berninger MT, Kaltenhauser T, Schoenfelder M, Vogt S, Wexel G, Tischer T, Sudkamp N, Niemeyer P, Imhoff AB, Schöttle PB, Sportbiologie, and Salzmann GM, Sauerschnig M, Berninger MT, Kaltenhauser T, Schoenfelder M, Vogt S, Wexel G, Tischer T, Sudkamp N, Niemeyer P, Imhoff AB, Schöttle PB

Abstract

Matrix-assisted chondrocyte transplantation (m-ACI) still lacks any standardization in its execution in terms of cell passage (P), cell yield (C) and in vitro membrane-holding time (T). It was the goal of this study to analyze the effect of shifting cell culture parameters (P, C, T) on the in vitro as well as in vivo effort of a regulated animal m-ACI. Autologous rabbit knee articular chondrocytes were seeded within bilayer collagen I/III 3-D matrices in variation of P, C and T. Each time, 2 PCT-identical by 2 PCT-identical cell-matrix-constructs (CMC)/animal were created. Simultaneously 2 (PCT-distinct) were re-implanted (CMC-e) autologous into artificial trochlear pristine chondral defects in vivo to remain for 12 weeks while the remaining 2 were harvested (CMC-i) for immediate in vitro analysis at the time of transplantation of their identical twins. mRNA of both, CMC-e regenerates and CMC-i membranes, was analyzed for Collagen-1,-2,-10, COMP, Aggrecan, Sox9 expression by use of a mixed linear model, multiple regression analysis. Generally, CMC-i values were higher than CMC-e values for differentiation targets; the opposite was true for dedifferentiation targets. Regarding individual gene expression, in vivo regenerate cell-matrix properties were significantly dependent on initial cell-matrix in vitro values as a sign of linearity. The parameter membrane-holding time (T) had strongest effects on the resulting mRNA expression with slightly less impact of the parameter passage (P), whereas cell yield (C) had clearly less effects. Noting differences between in vitro and in vivo data, in general, optimal expression patterns concerning chondrogenic differentiation were achieved by few passages, medium cellular yield, short membrane-holding time. Clinical m-ACI may benefit from optimal orchestration of the cell culture parameters passage, yield and time.

Published
2010

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