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Carolin Rickert,1,* Ulrike Fels,1,* Georg Gosheger,1 Tobias Kalisch,1 Dennis Liem,2 Sebastian Klingebiel,1 Kristian Nikolaus Schneider,1 Dominik Schorn1 1Department of General Orthopedics and Tumor Orthopedics, Münster University Hospital, Münster, Germany; 2Sporthopaedicum Berlin, Berlin, Germany*These authors contributed equally to this workCorrespondence: Carolin RickertDepartment of General Orthopedics and Tumor Orthopedics, Münster University Hospital, Albert-Schweitzer Campus 1, Gebäude A1, Münster, 48149, GermanyEmail carolin.rickert@ukmuenster.deObjective: Although many findings on occupational musculoskeletal complaints are available from American and European dentists, the corresponding data from Germany are still scarce. Therefore, the aim of this study was to provide additional information on the prevalence of and risk factors for musculoskeletal disorders of the upper extremity, particularly the shoulder in this specific population.Methods: A written survey was carried out among 600 dentists in the state of North Rhine-Westphalia, Germany. Questionnaire items included physical and psychosocial workload, general health, and the occurrence of musculoskeletal symptoms during the previous 12 months that led to sick leave and medical care according to a modified version of the Nordic Musculoskeletal Questionnaire (NMQ). Regression analysis was used to evaluate relevant risk factors for severe musculoskeletal disorders.Results: A total of 229 dentists were participated in the study (response rate 38%). Overall, 92.6% of the participants had already suffered from musculoskeletal symptoms in at least one body region. Symptoms were mostly reported in the neck (65.1%) and in the shoulder (58.1%). Limitations in daily activities were experienced by 15.9% due to neck pain and by 15.4% due to shoulder pain. Medical care was sought by 23.7% because of neck pain and by 21.1% due to shoulder pain. Risk factors for symptoms in the upper extremity regions were gender (female), increased physical load, and numerous comorbidities.Conclusion: There is a high prevalence of musculoskeletal disorders among dentists. Suitable interventions are therefore needed to prevent musculoskeletal diseases and pain among dental professionals, with particular attention to female dentists.Keywords: musculoskeletal disease, prevalence, dentists, risk factors, occupational exposure

Tobias Kalisch,1 Frank Horst,2 Georg Gosheger,1 Christoph Theil,1 Leonie Seeber,1 Burkhard Moellenbeck1 1Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, 48149, Germany; 2Department of Orthopedics and Traumatology, St. Josef-Stift Sendenhorst, Sendenhorst, 48324, GermanyCorrespondence: Tobias KalischDepartment of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Albert-Schweitzer-Campus 1, Muenster, 48149, NRW, GermanyTel +49 251 8347984Email tobias.kalisch@ukmuenster.deBackground: Osteoarthritis (OA) is a frequent cause of pain and disability, affecting half of the world’s population aged 65 years or older. Due to experienced pain and limitations, OA patients generally spend most of their waking hours sedentary and fail to adhere to physical activity (PA) recommendations. As a result of living together with OA patients, their partners might adopt a sedentary lifestyle. This study investigates the change in habitual PA and sedentary behavior (SB) in patients and their partners one year after the patients’ total joint replacement (arthroplasty) and inpatient rehabilitation.Methods: This is a follow-up of a prospective cohort study including 24 older couples (69.3± 7.8 years, gender ratio 11:13) consisting of OA patients (17 hip OA, 7 knee OA) and their partners. The participants’ habitual PA and SB were assessed by means of synchronous accelerometry (16h per day, 4– 7 days) and additional self-report.Results: Although the partners (∼ 6300 steps per day) were significantly more active than the patients (∼ 4800 steps per day) before arthroplasty, their lifestyle was still classified “low active”. Irrespective of the method used, the PA and SB parameters of patients and partners were significantly correlated before arthroplasty (accelerometry: r≥ 0.333, p≤ 0.001; self-report: r≥ 0.569, p≤ 0.004). Following the patients’ arthroplasty, no improvement in PA or SB was observed either in the patients or their partners. A detailed evaluation of accelerometric data on hourly basis revealed no change in behavior for both groups. Furthermore, their everyday activities remained correlated (accelerometry: r≥ 0.418, p≤ 0.001; questionnaire: r≥ 0.554, p≤ 0.005).Conclusion: One year post-arthroplasty and inpatient rehabilitation neither the OA patients nor their partners had changed their PA or SB. Their everyday physical activity was still strongly intertwined. Further research is needed to determine why behavior change does not occur even though the prerequisites are in place.Keywords: osteoarthritis, dyads, physical activity, sedentary behavior, arthroplasty

Burkhard Moellenbeck, 1 Tobias Kalisch, 1 Georg Gosheger, 1 Frank Horst, 2 Leonie Seeber, 1 Christoph Theil, 1 Tom Schmidt-Braekling, 1 Ralf Dieckmann 1 1Department of General Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany; 2Department of Orthopedics and Traumatology, St. Josef-Stift Sendenhorst, Sendenhorst, GermanyCorrespondence: Burkhard MoellenbeckDepartment of General Orthopedics and Tumor Orthopedics, Münster University Hospital, Albert-Schweitzer-Campus 1, Building A1, Münster 48149, GermanyTel +49 251 83-45539Fax +49 251 83-47989Email Burkhard.Moellenbeck@ukmuenster.dePurpose: The present study investigates behavioral conformity regarding physical activity (PA) and sedentary behavior (SB) in older couples where one partner suffers from osteoarthritis (OA). Hereby the question is addressed whether and to what extent the typical physical limitations of OA patients have negative effects on their partners.Patients and Methods: The habitual PA and SB of end-stage osteoarthritis patients (n = 32, 52– 81 years | n = 14 gonarthrosis, n = 18 coxarthrosis), their spouses (n = 32, 50– 83 years) and control couples (n = 26 subjects, 52– 78 years) were assessed by accelerometry. Besides individual results of accelerometry hourly couple-specific performance ratios were calculated for four parameters of PA (number of steps, vector magnitude (VM), metabolic rate (MET), and total time in moderate-to-vigorous PA (MVPA)) and two parameters of SB (number of sedentary bouts and total time of sedentary bouts per hour). Analyses of covariance were used to explore differences in hourly couple-specific performance ratios between couples affected by osteoarthritis and control couples.Results: Significant differences in PA were observed between the three groups, whereby the patients showed the lowest PA and the subjects of the control group the highest PA. In contrast to this, SB did not differ between the three groups. The hourly analyses of couple-specific performance ratios revealed significant differences between the target couples (patients and spouses) and the control couples for all parameters of PA. Thereby, the deviance in PA between the patients and their spouses was always smaller than in control couples and also decreased with age. The investigation of SB, on the other hand, revealed larger deviations between the patients and their spouses as compared to control couples and no changes with age.Conclusion: This study confirmed the known negative impact of osteoarthritis on the PA and SB of elderly patients. More important, however, was the finding that the patients’ spouses adapt to this poor health behavior and show reduced PA as well. Consequentially, spouses of OA patients should be considered as a risk group for inactivity-related diseases in old age. This should be considered in interventions that aim to use the individual support of spouses to increase the PA of OA patients.Keywords: older couples, osteoarthritis, inactivity, synchrony, accelerometer

BackgroundFour international study groups undertook a large study in resectable osteosarcoma, which included two randomised controlled trials, to determine the effect on survival of changing post-operative chemotherapy based on histological response.Patients and methodsPatients with resectable osteosarcoma aged ≤40 years were treated with the MAP regimen, comprising pre-operatively of two 5-week cycles of cisplatin 120 mg/m(2), doxorubicin 75 mg/m(2), methotrexate 12 g/m(2) × 2 (MAP) and post-operatively two further cycles of MAP and two cycles of just MA. Patients were randomised after surgery. Those with ≥10% viable tumour in the resected specimen received MAP or MAP with ifosfamide and etoposide. Those with

Purpose: There has been a renewed interest in the repair of the torn anterior cruciate ligament (ACL). Purpose of this study was to evaluate the functional outcome of arthroscopic ACL repair with additional suture augmentation (SA), hypothesizing that isolated ACL ruptures would yield superior patient-reported outcome measures (PROMs) compared to those with concomitant meniscal and/or ligamentous injuries. Methods: This is a retrospective analysis of 93 consecutive patients (67 female, median age 42 years) who underwent arthroscopic ACL repair with SA between January 2017 and March 2019 for an acute traumatic ACL tear confirmed by magnetic resonance imaging (MRI). Patients with pre- or intraoperative mid-substance or distal ACL tears and/or poor tissue quality of the ACL remnant were not considered for ACL repair but were scheduled for an ACL reconstruction with a tendon autograft. In patients who underwent ACL repair with SA, the SA construct was proximally stabilized with a flip-button and distally with a suture anchor. Surgery was preferably performed on the day of injury and all surgeries were performed by the same surgeon. Postoperative rehabilitation included partial weight-bearing (20 kg) for 6 weeks and immobilization in a brace limited at 90-degrees of knee flexion for 4 weeks. Patient-reported outcome measures (PROMs) were determined using International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Lysholm Score (LS), Tegner Activity Score (TS) and Forgotten Joint Score (FJS). Knee-laxity was assessed using the KT-1000 arthrometer (Med Metrics Corp. Inc., San Diego, USA). Results: Nine patients underwent revision surgery for a traumatic re-tear (four patients) and chronic instability (five patients) and were excluded from further functional analysis. Functional results of 77 patients (54 female) with a median age of 44 years (IQR 33–51) on the day of surgery were available for follow-up after a median time of 35 months (IQR 33–44). Concomitant injuries were observed in 66 Patients (86%), meniscal injuries in 43 patients (55%) and ligamentous injuries in 50 patients (65%). Median interval from injury to surgery was 1 day (IQR 0–1) with 81% (62/77) of patients being treated within 24 h of injury. The median IKDC was 92 (IQR 86–99), the median LS was 95 (IQR 86–100), the median pre-traumatic TS was 7 (IQR 6–7), the median post-traumatic TS was 6 (IQR 5–7) with a non-significant median difference (TSDiff) of 0 (IQR 0–1). The median FJS was 95 (IQR 78–98). KT-1000 measurements were available in 34 of 77 patients with a median postoperative laxity compared to the uninjured side of 1 mm (IQR 0–2). Interval from injury to surgery, patients' age, body mass index (BMI), knee laxity and concomitant ligamentous or meniscal injuries had no statistically significant impact on postoperative PROMs (n.s.). Conclusion: Following arthroscopic ACL repair with SA good-to-excellent functional results were observed. However, a failure rate of 10% cannot be neglected and warrants further attention. Concomitant injuries to the meniscus and/or collateral ligaments do not seem to be associated with inferior PROMs. Level of evidence: Level IV. [ABSTRACT FROM AUTHOR]