THE CLINIC

Annual Report 2015

In this publication, masculine forms have sometimes been used for the sake of simplicity. In such cases, the feminine form is obviously implied, too.

Project management: Simone Marquart Concept, design, typography and pre-press: Schaffner & Conzelmann AG, Basel Photographs and illustrations: Descience, Lucerne and Schaffner & Conzelmann AG, Basel Departmental report images: Schulthess Clinic photographic documentation Schaffner &Conzelmann AG, Basel In this publication, masculine forms have sometimes been used for the sake of simplicity. In such cases, the feminine form is obviously implied, too. © Wilhelm Schulthess-Stiftung 2016 19008.0516.6500

Contents Annual Report 2015

Board of Trustees and Departments Board of Trustees and Departments Annual Report from the President Annual Report from the CEO Annual Report from the CFO Annual Report from the COO Annual Report from the Medical Advisory Board Annual Report from Quality Management

Annual Report 2015

Upper Extremity Orthopaedics and Hand Surgery Annual Report Technical report: Treatment strategies for intra-articular distal humerus fractures Technical report: Early return to sport thanks to coordinated interdisciplinary care Lower Extremity Orthopaedics Annual Report Technical report: Posterior cruciate ligament injuries – an often overlooked injury Technical report: Reaching the hip through the keyhole – what is possible today ? Foot and Ankle Surgery Annual Report Technical report: A new way of correcting painful hammer toe misalignments Spinal Surgery and Neurosurgery Annual Report Technical report: Osteoporosis fractures of the spine – a growing problem

5 8 10 12 13 15 16

19 22 27

29 31 33

37 38

41 43

Neurology Annual Report Technical report: Nerve cysts – a rare cause of nerve damage Technical report: The Swiss Concussion Center Paediatric and Adolescent Orthopaedics and Deformity Correction Annual Report Technical report: Elbow injuries during childhood

47 50 52

55 57

Anaesthesiology Annual Report

61

Rheumatology and Rehabilitation Annual Report Technical report: “Reactive” ankylosing spondylitis

65 68

Manual Medicine Annual Report

70

Internal Medicine Annual Report

72

Medico-Legal Affairs Annual Report

73

Sports Medicine Annual Report Report: External sports care Report: Golf Medical Center

75 76 79

Therapy and Training Annual Report

83

Teaching, Research and Development Annual Report Current and completed projects

87 94

Facts and Figures Income statement and balance sheet Auditors’ report Key figures and statistics Donations and acknowledgements Diagnoses and operations

106 112 114 117 118

List of Publications Publications

127

Board of Trustees and Departments

Board of Trustees and Departments Board of Trustees

Medical Advisory Board

Lower Extremity Orthopaedics

President Franz K. von Meyenburg*

Dr. med. Daniel Herren, Departmental Head (Chairman) Dr. med. Alfred Müller, Departmental Head Dr. med. Stefan Preiss, Departmental Head Dr. med. Deszö Jeszenszky, Departmental Head

PD Dr. med. Michael Leunig, Departmental Head Dr. med. Stefan Preiss, Departmental Head Dr. med. Thomas Guggi, Consultant (conservative) Dr. med. Laurent Harder, Senior Consultant PD Dr. med. Hannes A. Rüdiger, Senior Consultant Dr. med. Georg Baumann, Deputy Consultant Dr. med. Gabriel Hatzung, Deputy Consultant (conservative) Dr. med. Florian Naal, Deputy Consultant PD Dr. med. Gian Salzmann, Deputy Consultant Dr. med. Karolin Rönn, Deputy Consultant (conservative) Dr. med. Tomas Drobny, Senior Consultant and Head of the Golf Medical Center

Vice President Hans G. Syz* Treasurer Christian J. Engi* President of the Working Party Hans G. Syz* Members of the Board of Trustees Dr. iur. Beat M. Barthold* Dr. med. Bruno Bonin Lucius Dürr Prof. Dr. Detlef Günther Hans Gut* Dr. iur. Ursula Gut-Winterberger Theres Lepori Hans Ulrich Märki* Esther Maurer Konstantin von Schulthess René Stammbach Christoph Theler Dr. iur. Beat Walti Prof. Dr. med. lic. iur. Thomas B. Zeltner

Directorate Andrea Rytz, CEO, Director Rolf Tannò , CFO, Vice Director Martina Bürgi-Hawel , COO Managerial Staff Barbara Hofer, OIC Communication and Marketing Monika Lewandowski, Team Leader Directorate Secretariat Tobias Pressler, Project Manager Béatrice Tissot-Daguette, Quality Management Officer

* Member of the Working Party

Upper Extremity Orthopaedics Dr. med. Hans-Kaspar Schwyzer, Departmental Head Dr. med. Matthias Flury, Senior Consultant Dr. med. Fabrizio Moro, Senior Consultant Dr. med. Michael Glanzmann, Consultant Dr. med. Christian Jung, Deputy Consultant Dr. med. Christoph Kolling, Deputy Consultant Dr. med. Ortwin Pröbstl, Deputy Consultant Dr. med. Manuela Tomforde, Deputy Consultant Dr. med. Barbara Wirth, Deputy Consultant Senior Doctor Secretariat: Andrea Wüst, Natalie Grob, Rita Kurzbein, Claudine Meier, Mäggie Sennhauser

Hand Surgery Dr. med. Daniel Herren, Departmental Head Dr. med. Stephan Schindele, Senior Consultant Dr. med. Elvira S. Bodmer, Deputy Consultant Dr. med. Lisa Neukom, Deputy Consultant Dr. med. Silvia Kündig, Acting Deputy Consultant Senior Doctor Secretariat: Karin Siller, Mirjam Hostettler, Nathalie Reichmuth, Esther Strassmann

Senior Doctor Secretariat: Simona Oeschger, Daniel Rüegg, Barbara Birchmeier, Lisa Egli, Selina Eicher, Dijana Sonjic

Foot and Ankle Surgery Dr. med. Pascal Rippstein, Departmental Head Dr. med. Thomas Rutishauser, Senior Consultant Dr. med. Anette Lanz, Senior Consultant Dr. med. Petra Binzer, Deputy Consultant (conservative) Dr. med. Christian Hausmann, Deputy Consultant Dr. med. Jens Mainzer, Deputy Consultant Dr. med. Christine Otte, Deputy Consultant (conservative) Dr. med. Sabine Brunner, Doctor (conservative) Dr. med. Caroline Bachofer-Unverricht, Acting Deputy Consultant Senior Doctor Secretariat: Sandra Meier, Naemi Vögeli, Eveline Hauser, Silvana Schmid

5

Board of Trustees and Departments

Spine Surgery and Neurosurgery Spine Surgery Dr. med. Deszö Jeszenszky, Departmental Head Dr. med. Frank Kleinstück, Senior Consultant Dr. med. Tamás Fekete, Consultant Dr. med. Daniel Haschtmann, Deputy Consultant Dr. med. Ortwin Pröbstl, Deputy Consultant Senior Doctor Secretariat: Tiziana Nasso, Sandra Sommer Neurosurgery PD Dr. med. François Porchet, Departmental Head Hans-Jürgen Becker, Deputy Consultant Dr. med. Martin Sailer, Deputy Consultant Senior Doctor Secretariat: Carol Frei

Neurology Dr. med. Alfred Müller, Departmental Head Dr. med. Martin Sutter, Senior Consultant Dr. med. Andreas Eggspühler, Senior Consultant Prof. Dr. med. Jiří Dvořák, Senior Consultant Dr. med. Georg Egli, Consultant Dr. med. Oliver Häussler, Consultant Dr. med. Christian Lanz, Consultant Dr. med. Ute Kretzschmar, Deputy Consultant Dr. med. Eduard Scherer, Deputy Consultant Dr. med. Nina Feddermann-Demont, Head of the Swiss Concussion Center Dr. phil. Mario Bizzini, PhD Senior Doctor Secretariat: Maja Husistein, Alessandra Bichsel, Gaby Stiefel

Paediatric and Adolescent Orthopaedics and Deformity Correction Dr. med. Rafael Velasco, Departmental Head Dr. med. Hannes Manner, Senior Consultant Dr. med. Matthias Peter Tedeus, Deputy Consultant Dr. med. Sylvia Willi-Dähn, Deputy Consultant Senior Doctor Secretariat: Ingrid Sacco, Sybille Helling

Anaesthesiology PD Dr. med. Christian Keller, Departmental Head Dr. med. Silvio Bazzigher, Senior Consultant Dr. med. Madeleine Niederer, Senior Consultant Dr. med. Herbert Acker, Consultant Dr. med. Heinz Bruppacher, Consultant Dr. med. Christoph Diestelhorst, Consultant Dr. med. Imrich Greve, Consultant Dr. med. Daniel Hurschler, Consultant Dr. med. Peter König, Consultant Dr. med. Dave Mital Hitendu, Consultant Dr. med. Berthold Moser, Consultant Dr. med. Ulrich Pralat, Consultant Dr. med. Krisztina Slavei, Consultant Dr. med. Peter Träger, Consultant Dr. med. Murat Yildirim, Consultant Senior Doctor Secretariat: Ursula Grossmann, Maya Hungerbühler, Monika Rancetti, Sonja Schweizer

Rheumatology and Rehabilitation Dr. med. Inès Kramers-de Quervain, Departmental Head Dr. med. Jürg Oswald, Senior Consultant Dr. med. Anna Thoma, Senior Consultant Dr. med. Ralph Ringer, Consultant Senior Doctor Secretariat: Gamze Ter, Sejla Dzafic, Evelin Khadra

Manual Medicine Dr. med. Gérard Hämmerle, Senior Consultant Dr. med. Elisabeth Aschl, Deputy Consultant Matthias Forrer, Osteopath D.O. Verena Seehusen, Osteopath M.Sc.Ost. Senior Doctor Secretariat: Janine Eggler Amgarten, Barbara Frei

Internal Medicine Dr. med. Margrith Knecht, Senior Consultant Dr. med. Grozdana Bojanic, Consultant

Medico-Legal Affairs Dr. med. Georg Egli, Head of Medico-Legal Affairs Prof. Dr. med. Bogdan Radanov, Senior Consultant Senior Doctor Secretariat: Eveline Zogg

Sports Medicine Dr. med. Gery Büsser, Departmental Head Dr. med. Stefan Sannwald, Senior Consultant Dr. med. Carsten Friederich, Deputy Consultant Dr. med. Philipp Sacherer, Deputy Consultant Senior Doctor Secretariat: Bianca Krauer

6

Therapy and Training

Medical Services

Residents and Hospital Doctors

Stephan Rüdisühli, Head of Therapy and Training Remo Denzler, TL** for Spinal Physiotherapy Markus Dohm-Acker, TL** for MTT and Training Ulrich Maroska, TL** for Lower Extremity Physiotherapy Tom Rosenheck, TL** for Sports Physiotherapy Ralf Seidel, TL** for Performance Diagnostics Seraina Vital, TL** for Upper Extremity Physiotherapy Charles Mayor, TL** for Occupational Therapy

Martina Bürgi-Hawel, COO Ines Gurnhofer, Head of Operating Theatre Mehtap Kir, Head of Central Sterile Supply Unit Martina Lehmann, Education Officer Edith Meienberg, Hospital Hygiene Officer Stefan Pott, Head of Nursing Services Lothar Sakowski, Head of MTRA / Radiology Susanne Waldmeier, Head of Hospital Appointment Scheduling

Dr. med. Björn Behrmann Dr. med. Tim Briem Dr. med. Mara Brizzi Dr. med. Valentino Bruhin Michael Dittrich Dr. med. Marco Etter Quinten Felsch Dr. med. Nils Horn Jens Hutmacher Dr. med. Isaj Migena Dr. med. Jonas Benjamin Ihle Dr. med. Cyril Inauen Dr. med. Bettina Jerosch Dr. med. Markus Loibl Dr. med. Raluca Reitmeir Dr. med. Marco Schneider Daniel Sieczewicz Sina Tok Dora Tolnai-Szebeny Dr. med. Nils Ulrich Dr. med. Robert Vachenauer Alexander Wagner Dr. med. Guy Waisbrod Dr. med. Eva-Leena Zenk

Teaching, Research and Development PD Dr. phil. Laurent Audigé, Research Group Leader, Upper Extremities and Hand Surgery Dr. phil. Franco Impellizzeri, Research Group Leader, Lower Extremities Prof. Dr. phil. Astrid Junge, Research Group Leader, FIFA Medical Assessment and Research Centre (F-MARC) Dr. phil. Nicola Maffiuletti, Research Group Leader, Human Performance Lab (HPL) PD Dr. phil. Anne Mannion, Scientific Advisor, Spine Surgery and Neurosurgery Dave O’Riordan BSc, Administrative Research Group Leader, Spine Surgery and Neurosurgery Lic. phil. Martina Hersperger, Group Leader, Research Management

** Team leader

Controlling & IT / IS André Plank, Head of Controlling & IT/ IS Susanne Cornejo, Head of Medical Documentation Andreas Lütscher, Head of Photographic Documentation Sidonio Malheiro, Head of IT

Logistics Herbert Schmidt, Head of Logistics Andreas Ackermann, Head of Catering Stefanie Drengenberg, Head of Housekeeping Irene Hunn, Head of Central Purchasing and Pharmacy David Kreienbühl, Head of Kitchen Jörg Saluz, Head of Technical Services Giovanna Scigliano, Head of Archive / Post

Schulthess Clinic Bad Zurzach Dr. med. Lorenzo Ferrante, Consultant Dr. med. Thomas Kurz, Deputy Consultant Stefan Pott, Head of Nursing Services

Management Services

Consultants in other disciplines

Rolf Tannò, Vice Director, CFO Reto Christen, Head of Finance and Accounting Claudia Iseli, Head of Reception Esther Lattmann, Head of Human Resources Karin Proff Singh, Head of Patient Administration

Dr. med. Jürg Bösiger, Haematology/ Internist Prof. Dr. med. Arthur von Felten, Haematology / Internist Dr. med. Peter Siegrist, Internist Dr. med. Evelyne Suter-Meier, Internist Dr. med. Barbara Wirth, Internist Dr. med. Michel Trösch, Cardiologist Prof. Dr. med. Markus Vogt, Infectiologist

7

Annual Report from the President

On 1 January 2016, the Board of Trustees of the Wilhelm Schulthess Foundation elected Andrea Rytz as the new Director and CEO of Schulthess Clinic. With this appointment, the Board of Trustees has placed its trust in a seasoned professional with many years of experience in healthcare. Her previous role was Director of the Hirslanden Klinik Belair in Schaffhausen. Andrea Rytz brings fresh impetus, innovative spirit and proficiency to this top position at Schulthess Clinic. This will ensure that we can consolidate our leading position on the market with the help of our medical staff, clinic management team and all other employees. Our new Director and CEO bears the title “Executive Master of Business Administration” and has also completed a “Master of Advanced Studies in Health Service Management” degree at FHS St. Gallen University of Applied Sciences. Schulthess Clinic strengthens its scientific links with ETH Zurich After five years of cooperation, Schulthess Clinic and ETH Zurich are taking their partnership to the next level. The aim is to incorporate clinical issues into teaching, research and development at ETH, with a view to promoting the use of new technologies in treating patients with musculoskeletal problems. Schulthess Clinic plans to establish a tangible presence in the university environment in future. We teamed up with ETH to launch a joint course, which is the first of its kind, with Master’s students on ETH’s “Health Sciences and Technology” programme (Department of Health Sciences and Technology, D-HEST) attending the first lecture on clinically relevant topics from the field of orthopaedics. The new “Clinical Challenges in Musculoskeletal Disorders” course covered topics ranging from musculoskeletal diseases and current treatment methods to future challenges and possible approaches to dealing with them. Linking theory with issues that arise in everyday clinical practice offered the students a valuable opportunity to engage with practitioners and our experts. This interaction has already provided the basis for various Master’s theses. As a teaching clinic and a future part of the Hochschulmedizin Zürich (Zurich University Medicine) initiative, Schulthess Clinic is going even further in this regard: we are supporting Master’s and Ph D theses as well as further training and education in medical professions. Schulthess Clinic undergoes a makeover With its building extension, Schulthess Clinic has invested 90 million Swiss francs in taking a step forward into modern medical practice for the benefit of its patients. New milestones were reached in 2015, with the opening of the elegant restaurant on the first floor and the ground-floor bistro, as well as the light-filled entrance hall, the garden and various offices and practice areas. The last stage was completed in early 2016 when the “holding area” was opened. Thanks to the intensive expansion and renovation work that has been carried out over the past three years, Schulthess Clinic now meets the current requirements for a hospital equipped with state-of-theart infrastructure and technology.

8

President

New impetus, new partnerships and a new look – 2015 was a year of change

Swiss Concussion Center (SCC) The Swiss Concussion Center deals exclusively with concussion, particularly in connection with sporting injuries. Our Neurology and Sports Medicine departments have built up significantly more than 20 years of experience in this area. Last year, Schulthess Clinic joined forces with the Interdisciplinary Center for Vertigo and Balance Disorders in the Department of Neurology at University Hospital Zurich to set up the Swiss Concussion Center. A big thank you to all staff On behalf of the Board of Trustees, my thanks go to all members of the medical, nursing and therapeutic staff and also to those in charge of infrastructure and administration for their commitment – in spite of the difficult working conditions over the past three and a half years. As we entered the final stretch in 2015, you once again dealt superbly with all the hurdles and obstacles you faced.

F. K. von Meyenburg President Board of Trustees

The Wilhelm Schulthess Foundation We can look back on the past year with a great sense of satisfaction. Our busy programme confronted us time and again with challenging situations. In light of our extensive investments in teaching, research and development, we would also like to take this opportunity to appeal to you personally: we are grateful for your donations in support of our medical / clinical research projects and your contribution towards the further development of scientific excellence in Zurich as a centre of research in the interests of patients. We are already well into a new year at Schulthess Clinic and are putting our hearts and minds into everything we do. Changes to the Board of Trustees Christian J. Engi, Hans Ulrich Märki and Dr. iur. Beat Walti were re-elected to the Board of Trustees. New member of the Board of Trustees Dr. Ursula Gut Departure from the Board of Trustees Dr. Christian Huber has stepped down from the Board of Trustees after nine years of service. We would like to thank him for his commitment and dedication in the interests of the clinic. Promotions The Board of Trustees has promoted Dr. med. Anna Thoma to Senior Consultant in Rheumatology and Rehabilitation. Medical Advisory Board Departmental heads Dr. med. Daniel Herren and Dr. med. Dezsö Jeszenszky were re-elected to the Medical Advisory Board for a further year.

Franz K. von Meyenburg President of the Board of Trustees

9

Annual Report from the CEO Andrea Rytz took up the post of Director and CEO of Schulthess Clinic on 1 January 2016. Drawing on her skill and experience, she has initiated a clinic-wide “tour d’horizon”, carefully building up a picture of the capacity and

“My first 100 days have been focused on visiting all the departments. I am interested in the people, the processes of clinical practice and gaining impressions.” Andrea Rytz is taking her time over her “walking analysis of the current situation”. She went about establishing contact and holding discussions with all the departmental heads and senior consultants in the same open way as she did when introducing herself at the grassroots level, with the aim of identifying opportunities and making a note of them for the clinic’s strategy over the next three years. Areas of activity with distinctive features Based on her adept and innovative approach, Andrea Rytz is organising the clinic’s future areas of activity along clear lines. A set of key focal points for strategic development is already starting to come together: Customer focus: The high quality of Schulthess Clinic’s medical services is based on the principle of customer satisfaction – impressing internal and external customers is therefore the aim. Specific training sessions for staff are designed to develop the strategy into a convincing and motivating sense of unity. Referral management: Building and developing an appreciative and committed partnership with referring doctors Public and specialist events: Opportunities to get to know the fascinating and high-performance world of Schulthess Clinic Consolidation and processes: Well thought-out integration of the new infrastructure into existing processes and certification by external partners Special acknowledgement Andrea Rytz: “Martina Bürgi-Hawel (COO), Rolf Tannò (CFO) and Dr. med. Daniel Herren (Chairman of the Medical Advisory Board) have done an exceptional job managing the clinic on an interim basis during the transition period. They have dealt superbly with the challenges of dayto-day operations, reorganisation and their additional managerial duties – Martina Bürgi-Hawel, Rolf Tannò and Dr. med. Daniel Herren deserve my sincere thanks, and the staff have also expressed their gratitude to them.”

10

CEO

potential on offer.

A preferred employer and a centre for teaching, research and development Schulthess Clinic is a strong and well-established brand. The clinic offers an attractive working environment and is a reliable partner for all employees. One example of an outstanding project at the clinic is the introduction of systematic and effective talent management.

A. Rytz Director, CEO

Schulthess Clinic has ambitions to further expand its academic teaching and research activities. Working with established national and international institutions, universities and companies helps to strengthen the clinic’s leading role. New look: “Preventive – operative – innovative” Andrea Rytz: “With our new image campaign and our promise of ‘Preventive – operative – innovative’ service, Schulthess Clinic is freshening up its image and presenting itself as a pioneering brand. Our medical expertise lies in ensuring the mobility of our customers. We achieve this aim to the highest quality standards based on a patient-focused strategy.” We will be presenting the results of our building and renovation work – a significant milestone for us – to the public at our open day on 18 June 2016. I would like to invite you all to come and take a look behind the scenes at the clinic and talk to us to find out more about the services we offer. You will have the chance to take a tour of our new operating theatres and the state-of-the-art patient rooms, meet famous sports stars and much more besides. I and the entire team here at Schulthess Clinic look forward to seeing you there. Andrea Rytz CEO

11

Annual Report from the CFO

New accounting method brings transparency 2015 was the first year in which the annual accounts were prepared in accordance with the provisions of Swiss accounting and reporting law (Code of Obligations – CO). The previous year’s figures have been restated in line with the structure of these newly adopted accounting and reporting standards. Investing in the future – in human resources and facilities Schulthess Clinic can now look back on an intensive three-and-a-half-year period of construction of which 2015 was the culmination. We have invested in expanding our premises at Lengghalde 2 and in upgrading its operating equipment, chiefly funding the venture ourselves. As well as the fabric of our clinic buildings, we have also invested in our human resources, significantly increasing our headcount. These “contingency plans” have had an impact on the financial result for 2015, which turned out less positive for the reasons mentioned. Schulthess Clinic has thus invested in its future. The investments made in 2015 (and earlier) are unlikely to start paying for themselves any time soon. In the long term, however, the investments in our state-of-the-art infrastructure and our workforce will bear fruit. Figures on a par with 2014 Schulthess Clinic enjoyed further year-on-year improvement in terms of the services it provided. Patient numbers were up yet again in 2015. For instance, 7983 inpatients were discharged, up by 3.7 percent on the previous year – despite the major disruption caused by the expansion and refurbishment work. Operating income remained on a par with the previous year due to the change in the patient mix (ratio of patients with supplementary insurance to those without). Modern clinic infrastructure, highly motivated staff and a financially healthy company form a firm foundation for a successful future. Rolf Tannò CFO

12

CFO / COO

The Wilhelm Schulthess Foundation is financially healthy and is investing in the future

Annual Report from the COO 2015 – a vital step towards a sustainable future The past year has probably been the most intense and difficult period for our patients and staff since our building work began in 2012, but it also offered ample opportunity to make further investments in the future sustainability of our institution at an administrative and educational level – with a great deal of commitment and with results that we can be proud of.

R. Tannò CFO Directorate

M. Bürgi-Hawel COO Directorate

Expanded premises and operational capacity This year, the building work mainly affected the “heart” of the clinic. While clinical operations were still running, more state-of-the-art operating theatres, a new recovery ward with intermediate care units and an additional X-ray room were installed, along with an extra bed lift system across all floors of the existing inpatient departments. At the same time, our Central Sterile Services department and our outpatient centre were expanded. And last but not least, 2015 also saw the construction of a new restaurant, the incorporation of a bistro into the new entrance hall, extensions to offices and practice areas, and the addition of a large auditorium. We are proud of the end results of this work and would like to take this opportunity to thank everyone concerned and involved, who have all contributed towards this success by continuously demonstrating an undiminished readiness to improvise and adapt in the face of the construction noise and numerous temporary measures. PR and administration Our website also underwent a “reconstruction”, with the new version having finally gone online in September 2015. As well as features such as an extensive and growing collection of specialist articles, the website now offers detailed information on a range of conditions and treatments. In addition to this, our project management team focused their efforts on further developing the EDP systems. The entire therapy planning process has now been switched over to a new system, making it more professional. With regard to the electronic clinic information system, the evaluation phase of the project was successfully completed and work began on the specifications and system structure. A pilot project has also been launched with a view to replacing our outdated telephone system. Continuing professional and personnel development In spite of the major challenges posed by the ongoing building work, we have never lost sight of our main concern, which is to ensure the safety and satisfaction of our patients. With this in mind, our priority this year was customer focus training. For the nursing staff, we managed to persuade the “grande dame” of nursing, Sister Liliane Juchli, to give a talk on the topic “From a holistic to a professional approach”, followed by a discussion session. A hand hygiene event was also held in a fresh attempt to raise awareness amongst staff of the importance of proper hand hygiene. Another area we have been “building” on is the future of our personnel, with our vocational trainers successfully devoting their efforts to training and nurturing young professionals. Their commitment was rewarded once again in 2015 with their trainees achieving excellent final results. In addition, we were able to cover our requirement for extra manpower as we expanded our operations in due time in spite of the scarcity of resources available on the market. This underlines the fact that Schulthess Clinic is a very attractive and extremely popular employer.

13

Medical Advisory Board

Annual Report Medical Advisory Board Schulthess Clinic undergoes a makeover Expanding the clinic has been both a success and a challenge. Having a modern, stylish look is great but we are not stopping there – in fact, we are already working hard on making the most of our newly acquired capacity and improved infrastructure with an eye on the future and the interests of our patients – true to our motto: “Preventive – operative – innovative”.

Dr. med. D. Herren Departmental Head (Chairman)

Dr. med. D. Jeszenszky Departmental Head

Dr. med. A. Müller Departmental Head

For Schulthess Clinic, 2015 was dominated by the completion of a two-year expansion project. The last stretch towards the finishing line involved putting the final touches on facilities such as the entrance hall and the new operating theatres. Anyone coming to the clinic in the run-up to Christmas was therefore immediately struck by our new makeover. Never have we seen so many patients and visitors taking photos of the clinic on their mobile phones. However, the new look is also reflected in our everyday clinical practice. An attractive outward appearance motivates us to further enhance what goes on inside. Our aim is to implement our new motto: “Preventive – operative – innovative”. “Preventive” refers, of course, to prevention. Through targeted measures, it is possible to keep our musculoskeletal system fit even in old age. One of the core areas of expertise at Schulthess Clinic is performing high-quality, technically sophisticated surgical – or “operative” – interventions when all other therapeutic options have failed or are not viable. Using “innovative” methods and implants, we aim to restore the functionality of the musculoskeletal system and / or improve painful conditions that have a negative impact on quality of life. Aside from its visual connotations, the word “look” is also associated with the phrase “to look after” – i. e. to provide the best possible care and treatment. The Medical Advisory Board is working with the Management Team to develop the strategic framework for putting this vision into practice. The conditions for this were rather unusual in 2015, as a change of CEO was due to take place and alterations were made to the composition of the Medical Advisory Board during the transition period. Nevertheless, we managed to bring what was not an entirely straightforward year to a positive end, paving the way for the new Director and CEO Andrea Rytz to assume her role in December in a highly motivated environment. As Phil Knight, the founder of Nike, once said: “Building a company is as creative as painting a picture or writing a book.” In fact, it is precisely this creativity that makes the job of managing a clinic so interesting and exciting. Identifying problems at an early enough stage and then tackling them in a targeted way is a challenge. In the interests of ensuring steady growth based on careful consideration, an intensive trialogue is maintained between the medical staff, the Directorate and the Board of Trustees. Schulthess Clinic does not just want to look good – more importantly, it wants to be a well-functioning institution that offers patients top-quality orthopaedic services.

Dr. med. S. Preiss Departmental Head

15

Annual Report Quality Management Quality of care consistently stands up to scrutiny Since the ground-breaking ceremony for the building extension at Schulthess Clinic in 2012, we have been paying particular attention to the quality of the services we offer. After all, it was essential that the difficulties caused by the building work for day-to-day clinical practice did not impact on the high quality and professionalism of the

Internal patient survey The clinic’s performance is assessed on the basis of continuous internal patient surveys conducted by means of questionnaires. As “customers”, our patients serve as a performance barometer for our clinical operations. The quarterly assessment sheds light on where our strengths lie and where improvement is still needed. All feedback, be it criticism or praise, is passed on to the relevant departments and analysed internally in order to come up with appropriate measures for optimising services. Patients are also contacted by telephone upon request. In 2015, 7982 patients underwent inpatient treatment at our clinic, with 38 percent providing feedback on the time they spent here. Overall, 96 percent of our patients were satisfied with their stay and would recommend Schulthess Clinic to others. External patient survey Since 2012, Schulthess Clinic has been taking part in the annual Switzerland-wide survey on patient satisfaction conducted by the National Association for Quality Development in Hospitals and Clinics (ANQ). National Patient Survey 2012 – 2015 9.8 9.6 9.4 9.2 9 8.8 8.6 8.4 Would you return to this hospital for the same treatment?

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How do you assess the quality of the treatment you received?

Did you receive Did you receive comprehensible comprehensible answers from doctors answers from nurses to any questions to any questions you may have had? you may have had?

Were you treated with respect and dignity during your hospital stay?

Schulthess Klinik 2013

Schulthess Klinik 2014

Schulthess Klinik 2015

CH reference value 2013

CH reference value 2014

CH reference value 2015

Quality Management

care provided.

Risk management – internal reporting portal Schulthess Clinic has an internal reporting portal, which is accessible to all members of staff. This portal is used for reporting: critical incidents (near-miss incidents) vigilance-related events (incidents involving medication, blood products or medical devices) other incidents (falls, bedsores and general incidents) Once the reported cases have been analysed by those accountable for the relevant area of responsibility and / or interdisciplinary committees, appropriate measures for improvement are defined and specified.

Use of the CIRS (critical incident reporting system) is an obligation imposed by the Canton of Zurich and directly linked to the performance mandate. Patient safety – hygiene Hospital hygiene deals with current problems at the clinic and developments that could affect the clinic in future with regard to nosocomial (hospital-acquired) infections. It helps to ensure that hospital infections are prevented, identified and combated. One of the main causes of nosocomial infections is the transmission of pathogenic germs via the hands of medical staff. For this reason, another hand hygiene event was held in 2015. Events like this offer clinic staff the opportunity to examine and review the way they personally deal with hand hygiene in order to ensure that the infection rate remains at a low level in future, too. Infection rates 2 1.5 1 0.5

Post-operative early infections %

2015

2014

2013

Year

0 2012

B. Tissot-Daguette Quality Management Officer

The purpose of the reporting portal is to: learn from errors and near-misses avoid future errors promote an internal zero-error culture record incidents that must be reported

Infections from external sources %

International average 1.5 % –2 %

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Upper Extremity Orthopaedics and Hand Surgery

Annual Report Upper Extremity Orthopaedics and Hand Surgery Cutting-edge technology and administration with proven specialist expertise The high level of specialisation within our team paves the way for providing expert care even in the case of complex medical problems relating to the upper extremities and the hand. Our top priority is always to ensure that our patients receive the best standard of treatment.

To guarantee an efficient service, our departmental operations have to be continuously optimised, taking changing circumstances into account. During the course of the year, for example, we made further improvements to our website. As a result, our patients are now also using the online registration function via [email protected] and [email protected] more often. This allows us to record patients in the system in a targeted way and schedule appointments quickly and efficiently.

Dr. med. H.-K. Schwyzer Departmental Head Upper Extremity Orthopaedics

Dr. med. M. Flury Senior Consultant Upper Extremity Orthopaedics

Dr. med. F. Moro Senior Consultant Upper Extremity Orthopaedics

One of our main concerns is to provide our patients with personalised care as far as possible, from the initial consultation through to surgery and the discharge check-up. Our doctors responsible for conservative treatment, Dr. med. Silvia Kündig, Dr. med. Manuela Tomforde, Dr. med. Rainer-Peter Meyer and Dr. med. Urs von Wartburg, do their best to minimise waiting times before the actual treatment starts. New technical and building developments Since operations on the upper extremities, especially the shoulder, are now largely carried out in a minimally invasive way using arthroscopic techniques, the opening of the arthroscopy unit in the surgical wing in spring 2015 was a particular milestone for our department. We and our patients now enjoy access to state-of-the-art infrastructure, which also enables surgical procedures to be optimised. A “holding area” is one of the facilities due to be completed in the coming year. This is intended to serve as a reception area for patients awaiting treatment with an empty stomach, guaranteeing maximum efficiency along with excellent patient safety. During this year, the ongoing building work in the central part of the clinic meant that the staff in our department had to show a high degree of flexibility and initiative in order to keep operations running smoothly. Despite various secretary’s and doctor’s offices within the department having to be relocated, we managed to continue providing consultations and operations without any restrictions – anything but a given under such conditions. All of our staff deserve the highest praise for their efforts in this regard. We are also grateful to our patients for keeping faith with us in spite of these adversities. Recognition in Switzerland and abroad The year under review also saw us gain further recognition for our expertise on the international stage, thanks to our doctors being invited to speak and perform live surgical demonstrations at prestigious congresses and producing highly regarded specialist publications.

Dr. med. M. Glanzmann Consultant Upper Extremity Orthopaedics

To be continued ...

Another book project, this time on the topic of “Langzeitresultate in der Extremitäten- und Wirbelsäulenchirurgie” (“Long-term outcomes from surgery on the extremities and spine”), was completed under the direction of Dr. med. Rainer-Peter Meyer and published by Springer-Verlag. This presents some remarkable long-term outcomes over periods of 20 years or more and features contributions from a number of well-known experts.

19

At the same event, Dr. med. Urs von Wartburg, former Head of the Hand Surgery Department at Lucerne Cantonal Hospital and now working as a hand surgeon specialising in conservative treatment at Schulthess Clinic, was elected as an honorary member of the Swiss Society for Hand Surgery – congratulations to him ! In addition, our department also had the pleasure of welcoming numerous visiting physicians over the past year, some of whom came here from abroad. Scientific excellence in both theory and practice The lively activity of our Research department is of crucial importance to us. Under the leadership of PD Dr. phil. Laurent Audigé and Dr. med. Christoph Kolling, the follow-up registries, which stand up to the stringent requirements of the Cantonal Ethics Committee, have been further expanded. They provide proof of the quality of our services and form the basis for a large part of our scientific activities. Various works from the field of hand and upper extremity surgery were published during the year. Of particular interest were two articles on hand surgery, which looked into patient satisfaction and the fulfilment of treatment expectations in connection with osteoarthritis of the thumb carpometacarpal joint. They showed that surgical treatment for this problem met the expectations of almost 80 percent of patients, whereas only 25 percent were satisfied with non-surgical (conservative) treatment. Studies like these help us to optimise treatment pathways for certain conditions and provide a starting point for ensuring efficient use of resources during treatment. Another key focal area, aside from evaluating quality of life and cost-effectiveness, is the documentation and evaluation of complications. The aim of this is to formulate standards with regard to defining and documenting complications following surgery on the hand and the upper extremities and to enforce them at an international level. In addition to its scientific activities, our team continues to be involved in developing cutting-edge prosthetic systems for the shoulder and hand. The work, which began in 2014, on developing a new prosthetic thumb carpometacarpal joint replacement was also taken further. Thanks to generous support from the Baugarten Foundation, the biomechanical analyses have largely been completed and the patent document has been submitted to the Patent Office. The first trial implant procedures have also already been carried out. With the help of modern 3D printing technology, it is possible to produce the prototypes needed for this quickly and economically. The objective is to finalise the prosthesis design in the first quarter of the year, so that we can then get started on the biomechanical tests. The first implantations in patients are not expected to take place before early 2017 at best.

20

Upper Extremity Orthopaedics and Hand Surgery

As in previous years, one of the highlights on the congress calendar in 2015 was the Annual Congress of the Swiss Society for Hand Surgery (SGH). Schulthess Clinic was amongst the participants in the areas of hand surgery and hand therapy, making numerous contributions that gained those involved a great deal of recognition. Our occupational therapist colleague, Ellen Dietrich, even won first prize for making the best and most innovative contribution.

Dr. med. C. Kolling Deputy Consultant Upper Extremity Orthopaedics

Promoting young talent As always, we have been paying particular attention to the training and education of our young doctors. It is no coincidence that, in the area of hand surgery, for example, two deputy consultant positions are being held by colleagues who are about to begin their medical specialisation or have recently completed it. Due to the exceptionally high number of cases we deal with, further sub-specialisation in arthroscopic techniques, joint prosthetics, treatment for fractures, and elbow and shoulder surgery is also essential in our specialist area. It is important for us to carefully impart the required specialist knowledge to our young doctors and introduce them to the surgical techniques involved, some of which can be quite complex, so that we as a department can continue to meet the demands on our expertise in future. Changes in personnel In the year under review, Dr. med. Barbara Wirth and Dr. med. Christian Jung were promoted to deputy consultants and Dr. med. Felix Toft to acting deputy consultant.

Dr. med. C. Jung Deputy Consultant Upper Extremity Orthopaedics

Deputy consultant Dr. med. Holger Durchholz left our department for the Upper Engadine valley, where he was ideally equipped to take on a position of responsibility at Klinik Gut. We wish him every success and all the best.

Dr. med. F. Toft Deputy Consultant Upper Extremity Orthopaedics

Dr. med. M. Tomforde Deputy Consultant Upper Extremity Orthopaedics

To be continued ...

21

Technical report: Upper Extremity Orthopaedics Treatment strategies for intra-articular distal humerus fractures

Distal humerus fractures in adults account for around 3 percent of all fractures of the extremities. They are rare injuries, affecting approximately 5 to 6 of every 100 000 people in Switzerland, and they occur primarily in young, active, sporty males aged between 12 and 19 (“high-energy trauma”) and in women over the age of 60 with

When these figures are projected, the result is a total of around 400 of these injuries each year in Switzerland with its population of 7 million. These are very complex injuries that call for a great deal of skill on the surgeon’s part. Fractures per 100 000 people per year 30

20

10

Years

0 12–19 Men

20–29

30–39

40–49

50–59

60–69

70–79

80+

Women

Fig. 1 Distal humerus fractures are “problematic fractures” because the complication rates continue to be high, despite the development of modern implants, which are in part anatomically pre-shaped and which can be fixed in place using angular-stable screws. There are two reasons for the high complication rate: poor bone quality that is often found, especially in elderly women, and high level of biomechanical stress associated with these implants. Secondary loss of reduction is not uncommon and further surgery is sometimes required. Despite complex reconstructive surgery, it is often not possible to prevent limitations of range of motion. Irritation of the ulnar nerve is another complication that is not uncommon, due both to its immediate topographical proximity and its exposed course close to the surface of the body, with this problem occurring in up to 12 percent of cases. Patients who are affected often experience troublesome paraesthesia in little and ring fingers, sometimes resulting in the need for further revision to visualise the nerve and free it from scar

22

Upper Extremity Orthopaedics and Hand Surgery

largely osteoporotic bones (“low-energy falls”). The ratio of men affected compared to women is 1: 25 (Fig. 1).

Dr. med. B. Wirth Deputy Consultant Upper Extremity Orthopaedics

Fig. 2

Fig. 1 Demographic distribution of distal humerus fractures; Source: Rockwood and Green’s fractures in adults, Lippincott Williams & Wilkins; 7th Edition 2009 Fig. 2 Postoperative X-rays 1 year after treating a distal humerus fracture via an approach that preserves the extensor apparatus

tissue (decompression) as well as an anterior transposition of the nerve in some cases. Whether it is better to perform a subcutaneous anterior transposition of the nerve out of the sulcus as part of the primary osteosynthesis procedure in order to prevent irritation of the nerve or to leave it following its natural course in the sulcus is a subject of highly controversial debate, and there are no clear recommendations in this regard. However, it is generally agreed that the nerve needs to be exposed and inspected in cases where a neuropathy is present prior to surgery. Various approaches are described for the reconstruction of these fractures, from the triceps-sparing approach (Fig. 2; preservation of the extensor apparatus) to the osteotomy of the proximal ulna (olecranon osteotomy), which is the insertion point of the extensor apparatus. The surgeon is responsible for choosing the most suitable approach and this decision of course also depends on the location of the fracture. Fractures that extend into the joint are generally exposed by performing an olecranon osteotomy, i. e. the elbow extensor apparatus is cut at its bony insertion point (proximal ulna) and can therefore be folded back to provide good exposure of the injury. Refixation of the osteotomy is then required (Fig. 3).

Fig. 3 Dorsal approach using an olecranon osteotomy; refixation of the osteotomy by means of plate osteosynthesis and cerclage wire Fig. 3

23

As a general rule, conventional radiological imaging in two planes is not sufficient when planning the operation. Computed tomography, including three-dimensional reconstruction, simplifies surgical planning nowadays and is a useful addition (Fig. 4). This technique allows intra-articular extensions of fractures to be clearly visualised and the ability to assess the sustained injury is improved. Computed tomography can also be useful for selecting the best approach. Surgical treatment of distal humerus fractures in adults is the treatment of choice. The aim must be to achieve osteosynthesis that does not require postoperative immobilisation, thus allowing for early functional follow-up treatment. In order to achieve this aim, angular-stable plate systems should be used that offer an element of free choice in terms of the positioning of the screws. Whether the angular stability should be unidirectional or multidirectional is also a controversial issue, but these systems are nevertheless an excellent addition to the range of standard plates. In terms of plate positioning, it should be mentioned that the parallel plate position offers biomechanical benefits (Fig. 5). However, this requires more bone exposure, which can in turn lead to problems with circulation. Positioning plates at right angles to one another (Fig. 6) is also still advocated today and is a good option. The decision about how the plates should be placed in relation to one another is ultimately an individual one. In the case of elderly patients, many of whom have osteoporosis, which means that it is not possible to stabilise the fracture in an acceptable way, or who have pre-existing severe osteoarthritis or rheumatoid arthritis, the option of joint replacement surgery can also be considered. Prostheses with cement are used. A general recommendation cannot be made in this regard either. Only the following can be said:

Fig. 5

24

Fig. 6

Upper Extremity Orthopaedics and Hand Surgery

Fig. 4

Fig. 7

Fig. 4 Three-dimensional reconstruction of an intra-articular distal humerus fracture, with views in various projections Fig. 5 AP X-ray, projection with parallel plate position in medial and lateral columns (180 /180 degree configuration)

female, 75

2 years

In the case of elderly women over the age of 65 with a multifragmentary distal humerus fracture, an artificial elbow joint offers a viable alternative with comparable results (Fig. 7). Trochlea and capitellum fractures constitute a particular type of intra-articular distal humerus fracture, because they affect only the joint-bearing, i. e. cartilage-bearing part. Based on a case study, the aim is to demonstrate that even these complex injuries involving the joint can be operated on successfully using suitable implants that are available nowadays and in a way that preserves the joint and offers a good functional outcome (Fig. 8 and 9).

Fig. 6 AP X-ray showing a right-angle positioning of the plates (90 / 90 degree configuration) Fig. 7 Three-dimensional representation of a multifragmentary intra-articular distal humerus fracture in a 75-year-old female patient with documented osteoporosis, treated with a replacement elbow joint. Follow-up X-rays 2 years postoperatively.

Fig. 8

Fig. 8 Trauma and postoperative X-rays of a capitellum and trochlea fracture Fig. 9 The functional images one year after the operation show the very good progress with free flexion and extension. Fig. 9

25

To sum up, it can be said that distal humerus fractures in adults continue to be injuries that are difficult to treat due to their low incidence rate and, consequently, the low number of cases. They require great experience on the part of the surgeon.

Authors: Dr. med. Fabrizio Moro, Senior Consultant, Upper Extremity Orthopaedics, and Dr. med. Felix Toft, Deputy Consultant, Upper Extremity Orthopaedics

Fig. 10 a

Fig. 10 a Multifragmentary intraarticular distal humerus fracture

Fig. 10 b

Fig. 10 b Primary osteosynthesis performed elsewhere with subsequent secondary loss of reduction and resultant incongruence of the joint. Fig. 10 c Postoperative X-rays after complex revision with repeat osteosynthesis via an olecranon osteotomy

Fig. 10 c

26

Upper Extremity Orthopaedics and Hand Surgery

Reconstruction should be performed wherever possible and a further attempt at reconstruction is not contraindicated in a revision situation either, provided that there is sufficient stable bone stock available (Fig. 10).

Technical report: Hand Surgery Early return to sport thanks to coordinated interdisciplinary care

Professional ice hockey injuries involving the forearm and hand are not uncommon and are generally the result of a major and local impact of force. Surgical treatment is often required due to both the injury pattern and the athlete’s desire for the shortest possible rehabilitation period. Optimal cooperation between sports medicine and hand surgery during the follow-up treatment phase is key.

One of the Kloten Flyers’ top players sustained a left forearm fracture in January 2015 when he was struck by an opponent’s stick in an ice hockey foul. The powerful two-handed blow landed on the unprotected area between the elbow pad and the glove.

Dr. med. D. Herren Departmental Head Hand Surgery/ Orthopaedics

Dr. med. S. Schindele Senior Consultant Hand Surgery /Orthopaedics

Diagnostic investigation and surgical treatment The X-ray revealed a long spiral fracture of the radius with clear displacement of the fragments (Fig. 1). Surgery to reduce and fix the fracture was clearly indicated. The aim of surgery of this kind is to restore the normal anatomical conditions as effectively as possible and to guarantee rapid healing of the bone through stabilisation and compression. The radius was successfully aligned intraoperatively and stabilised using a strong, long plate. The postoperative healing took place without any complications. Early return to the ice After just four weeks, there were clinical and radiological signs that the bone was healing (Fig. 2), so a cautious return to on-ice training was initiated. In this particular case, every day counted for this key player’s return to the team, which was in a precarious position in terms of its position in the league table. By mutual agreement, the Sports Medicine department fitted a specially made and well-padded splint which could be worn inside the player’s glove. The patient was therefore able to handle the hockey stick with the injured hand and was sufficiently well protected to be able to resume his regular play after just five weeks. Conclusion The medical team responsible for the player’s care was delighted to see that the player was able to resume his original position during his very first match following his return from injury and that he made a key contribution to the team’s success with two assists and one goal. The case illustrates how optimal cooperation between a patient and a team of healthcare professionals from both conservative and surgical disciplines can enable top performances in elite sport.

Dr. med. E.S. Bodmer Deputy Consultant Hand Surgery / Orthopaedics

Fig. 1 Trauma X-ray Fig. 2 Follow-up X-ray 4 weeks after the operation

Dr. med. L. Neukom Deputy Consultant Hand Surgery / Orthopaedics

Fig. 1

Fig. 2

27

Lower Extremity Orthopaedics

Annual Report Lower Extremity Orthopaedics The Lower Extremities department continues to grow In 2015, our professional and motivated team once again lived up to its outstanding international reputation as a highly specialist reference centre for hip and knee surgery. This is something we are very proud of.

PD Dr. med. M. Leunig Departmental Head Hip Surgery

Dr. med. S. Preiss Departmental Head Knee Surgery

Dr. med. L. Harder Senior Consultant Knee Surgery

2015 was a period of consolidation for the department, since the move into the ground floor of the new “West” extension in 2014 had given the Lower Extremities team the extra space we urgently needed for our group practice. The daily consultations in the new, spacious practice rooms form the basis for our surgical activities. A total of 32 600 patients, most of whom had been referred by GPs, were assessed and treated in the Hip and Knee Surgery department last year – a 10 percent increase on the previous year. Our expanded and cohesive practice team and extended infrastructure are essential in enabling us to manage such a huge number of patient contacts efficiently. In everything we do, we always endeavour to provide the most timely and professional care possible. Team / Personnel Due to its large patient intake and the administrative workload associated with this, the Lower Extremity Surgery department has the biggest workforce and is by far the largest department at Schulthess Clinic. We currently boast five senior doctors, including the departmental heads of the hip and knee teams, as well as five deputy consultant surgeons and ten junior doctors still undergoing training. The team also includes three doctors specialising in conservative treatment, who look after our outpatients as well. Fifteen secretaries, two departmental managers and two practice managers support the medical team. We have various items of news to report from the team: PD Dr. med. F. Naal has gained his qualification as a university lecturer in orthopaedics at his home university, the Technical University of Munich. The thesis he wrote for this deals with patient-oriented measurement of outcomes in orthopaedic surgery. In March 2016, PD Dr. med. Gian Salzmann was appointed as an associate professor at the University of Freiburg in Germany. Dr. med. Stefan Joss left our clinic at the end of 2015 to go into private practice in Bern and Dr. med. Philippe Neidenbach will be joining us in spring 2016 to replace him. The team welcomed a new member and conservative treatment specialist, Dr. med. Sandra Schwertner, on 1 December 2015. Dr. med. Gabriel Hatzung was promoted to deputy consultant for conservative treatment in the Lower Extremities team as of 1 September 2015. Knee and hip operations 5000 4000 3000 2000 1000

To be continued ...

2015

2014

0 2013

PD Dr. med. H. Rüdiger Senior Consultant Hip surgery

29

Trend in knee and hip prosthetics 800 600 400 200

Knee prosthesis replacement

Hip prosthesis replacement

Primary knee replacements

Primary hip replacements

Number of operations A total of 4797 surgical interventions were carried out on knee and hip joints in 2015, which is six percent more than in the previous year. Hip surgery Overall, 796 total hip replacements were performed in our department last year, which corresponds to a rise of almost two percent compared to the previous year. In over 85 percent of cases, interventions are now carried out through an anterior approach – a tried-and-tested, minimally invasive method – with patients currently spending an average of 8.9 days in hospital. The average period of hospitalisation following revision operations on the hip is 13.3 days. In addition, around 200 hip arthroscopies were performed during the year. This traditional, minimally invasive procedure has been developed significantly in recent years and it is now possible to carry out even complex reconstructions using the keyhole technique. Knee surgery 2015 saw 750 primary total knee replacements carried out, which is an increase of 20 percent on the previous year. With 133 knee prosthesis revision operations on our records, our department is also the largest revision facility in Switzerland by some distance. The average hospitalisation periods are 11.6 days for primary endoprosthetic treatment on the knee and 13.3 days in the case of revision procedures. The number of arthroscopic reconstructions and rare open cruciate ligament reconstructions has doubled over the past five years to 300. However, it is important to bear in mind that only 50 percent of ruptured cruciate ligaments are treated surgically – roughly one in two patients with cruciate ligament injuries achieve a good functional outcome through purely conservative treatment after a thorough investigation and assessment. The department is now also at the forefront of joint preservation in Switzerland, having carried out the most autologous chondrocyte implantation (ACI) procedures in the country in 2015. This method involves taking cartilage samples from the knee in an initial operation. Cartilage cells (chondrocytes) are then separated from the cartilage and propagated in a laboratory. In a second operation four weeks after the first one, these autologous chondrocytes (derived from the patient’s own body) are re-implanted to cover focal cartilage damage. This makes it possible to biologically preserve the functionality of the joint. Outlook With the building work at the clinic now largely completed, departmental operations have now fully returned to normal. This is having a positive effect on the satisfaction of our patients undergoing inpatient and outpatient treatment and on the overall atmosphere within the department. This and our continued growth give us cause to look to the future with optimism.

30

Lower Extremity Orthopaedics

2015

2014

2013

Year

2012

0

Technical report: Lower Extremity Orthopaedics Posterior cruciate ligament injuries – an often overlooked injury

According to the latest findings, both isolated and combined posterior cruciate ligament (PCL) injuries occur much more frequently than previously thought. What’s more, given the need for differentiated and prompt diagnosis and treatment, PCL injuries have now superseded anterior cruciate ligament injuries as the latest challenge within the world of knee surgery.

Causes of PCL injuries Posterior cruciate ligament injuries are often the result of a high-force impact, such as in traffic accidents (“dashboard injuries”), but these injuries are often overlooked. In some cases, even a more minor trauma (e. g. a direct trauma suffered by a goalkeeper in football) or a fall directly onto the knee can be enough to cause a PCL injury. With this injury, a force applied to the lower leg pushes it backwards. Dr. med. T. Drobny Senior Consultant in Knee Surgery and Head of the Golf Medical Center

Dr. med. G. Baumann Deputy Consultant

Diagnostic investigation and treatment In terms of diagnosis, it is important to distinguish between acute and chronic PCL injuries. With acute injuries, patients typically complain of pain in the hollow of the knee and only feel a sense of instability when their ligament injury is a combined one. In contrast, the predominant symptoms of chronic PCL injuries (i. e. those that are not recognised immediately) are pain in the patellofemoral joint region and a sense of instability. Since the PCL has great potential for healing spontaneously, it is only in rare cases that immediate surgery is indicated. Isolated PCL injuries are primarily treated conservatively. If other ligaments are also injured, surgical treatment may be required. With chronic PCL injuries, stress X-rays are used to compare the two sides and to establish whether the insufficiency is mild (difference between sides of < 5 mm), which is treated conservatively, moderate (difference between sides of 5–10 mm), which should only be treated surgically if symptoms are present, or severe (> 10 mm), in which case surgery is indicated. PCL reconstruction is normally performed as an arthroscopic procedure and tendon autografts are used in most cases. The right type of physiotherapy after the surgical reconstruction is also crucial for a successful outcome.

PD Dr. med. F. Naal Deputy Consultant

Prof. Dr. med. G. Salzmann Deputy Consultant

To be continued ...

31

Author: Dr. med. Gregor Baumann, Deputy Consultant, Lower Extremity Orthopaedics

Fig. 1

Fig. 2

Fig. 3

32

Lower Extremity Orthopaedics

A typical case study A 20-year-old male patient complained of diffuse pain in the anterior knee region, but without any sense of instability. The clinical examination revealed a non-fixed posterior drawer and this was documented in stress X-rays (see X-ray images). When questioned, the patient mentioned an ice hockey trauma, but was unable to give any more specific detail. Given the extent of the lesion and physical strain, the posterior cruciate ligament was replaced in an arthroscopic procedure. The patient has made an excellent recovery.

Technical report: Lower Extremity Orthopaedics Reaching the hip through the keyhole – what is possible today ?

The fact that hip arthroscopy has become a routine procedure is largely due to femoroacetabular impingement (FAI), also known as hip impingement. This condition is a known risk factor for early onset osteoarthritis of the hip in young adults.

Indications for hip arthroscopy FAI is a condition where the hip joint is abnormally shaped, meaning that certain movements cause mechanical conflict between the acetabulum and the neck of the femur. This results in increasing damage at the rim of the joint (labrum) and the cartilage, causing pain and, ultimately, more and more wear (osteoarthritis) of the hip. The aim of surgical treatment of FAI is to eliminate the mechanical conflict and, as far as possible, to reconstruct the damaged tissue. In most cases, this also reduces the painful symptoms. Dr. med. T. Guggi Consultant (conservative)

Dr. med. G. Hatzung Deputy Consultant (conservative)

Although it is still best to treat hip joints with complex deformities and / or cartilage damage in open surgery (surgical hip dislocation), symptomatic FAI can be treated very successfully using arthroscopic methods in the majority of cases (approx. 70 – 80 percent). Our specialist hip surgeons at Schulthess Clinic offer both methods, so the surgical technique that is best suited to the indication can always be used. As well as treating FAI, which is our main indication for hip arthroscopy, we can also use arthroscopy to treat other pathologies of the hip, although these do not account for high case numbers at our Clinic (< 5 percent). Such pathologies include, for example, isolated labral tears, conditions affecting the synovial membrane or ligamentum teres (central hip ligament), postoperative adhesions of the joint capsule and floating cartilage. Technique A traction table is used for hip arthroscopy. The traction (i. e. the pulling force on the leg) is needed to pull the hip joint “apart” by at least 5 millimetres to allow the surgeon to see into the joint. A general anaesthetic is used to ensure that the muscles are properly relaxed, as this makes the traction process easier. Three incisions (known as portals) are generally made, with each one measuring just under 2 cm in length and with partial use of fluoroscopy, so that all of the steps of the surgical procedure in the joint can be performed correctly.

Dr. med. K. Rönn Deputy Consultant (conservative)

Fig. 1 Posterior drawer 10 mm on the right Fig. 2 No posterior drawer on the left Fig. 3 PCL after reconstruction

33

Fig. 5

The operation starts by treating the pathologies both in and at the acetabulum, as well as at the labrum. The labrum is preserved if possible and sutured using suture anchors (Fig. 4 and 5). Several studies have now produced good evidence to show that suturing (refixing) a healthy part of the labrum leads to a better clinical outcome than removing it (resection). However, in certain cases. i. e. if the labrum is severely degenerated, a partial resection or debridement makes sense. The next step involves shaping the femoral head correctly in relation to the femoral neck – the femoral head is essentially “made round again” (offset correction). This is done under fluoroscopy and using a spherical burr (Fig. 6 and 7). At the end of the operation, movement is checked under visual observation (Fig. 8), thorough joint lavage is performed, the joint capsule is sutured in most cases and the final skin closure is performed.

Fig. 6

Fig. 7

Fig. 8

34

Lower Extremity Orthopaedics

Fig. 4

Complications The complication rate for hip arthroscopy is generally stated to be up to 5 percent. The most common complications are temporary dysaesthesia in the foot or groin region due to the patient’s position during the operation and the traction applied to the leg. Other risks are damage to cartilage or the labrum due to the operation or the extravasation of arthroscopy fluid into the abdominal cavity. Provided that the surgical technique is correct, the risk of a circulatory disorder at the femoral head (femoral head necrosis) is practically non-existent. In the treatment of FAI, overand under-correction should be regarded as avoidable complications; unfortunately this aspect is disregarded in most works from the more recent literature. Adhesions of the joint capsule are observed slightly more frequently (up to 5 percent). Not all adhesions produce symptoms or require treatment. However, larger adhesions cause symptoms, some of which are similar to the symptoms experienced before the operation. Although these adhesions do not cause any further damage to the joint, in some cases arthroscopic surgery needs to be performed again to break down the adhesions.

Fig. 4–5 The torn labrum is sutured back into place (refixed) using suture anchors that are inserted into the bone. Fig. 6–7 The abnormal shaping that is evident in the form of a “bump” at the femoral headneck junction is gradually removed using the spherical burr (offset correction) Fig. 8 In the final movement check, the joint is shown to have free movement following the labrum suture with three anchors and the offset correction.

Outcome With the correct indication, a good to very good outcome can be expected in 70 – 80 percent of cases. The greatest postoperative progress is made within six months of the operation and the final outcome can be assessed after about nine months. Depending on the progress made during the postoperative rehabilitation phase, the patient can return to light sporting activity after six to twelve weeks. Intensive sports involving jumping or stop-and-go sequences can be resumed after three to five months. Competitive athletes can expect to take part in competitions again after five to eight months, depending on the particular sport in question. In 15 – 20 percent of cases, patients are left with certain residual symptoms, which can lead to subjective dissatisfaction. Researchers are currently investigating the risk factors for an unfavourable outcome which, in some cases, can even make subsequent hip joint replacement surgery necessary. Clear risk factors that have already been identified include, in particular, the early signs of osteoarthritis of the hip at the time of the operation and advanced age of the patient. Patients who undergo hip arthroscopy at Schulthess Clinic are, on average, around 30 years old. Summary In the hands of an experienced surgeon, hip arthroscopy is a standard surgical procedure. In the majority of cases, the procedure is used to treat hip impingement. Good and very good outcomes are achieved in up to 80 percent of cases. In patients in whom the onset of osteoarthritis is already evident and / or in elderly patients, the indication should be made with caution. Author: PD Dr. med. F. Naal, Deputy Consultant

35

Foot and Ankle Surgery

Annual Report Foot and Ankle Surgery 2015 – a year of consolidation Rising patient demand, an international reputation as a centre of expertise and a recognised partner for further training and education – the Department of Foot and Ankle Surgery remains a strong, core component of Schulthess Clinic.

The expansion of our treatment centre allowed us to increase our treatment capacity and ensured that the number of consultations and operations carried out at our centre remained at a high level during the year under review. The new facilities have been in use since May 2015 and have received a very positive response from our patients thanks to their extremely pleasant ambience. Among other new developments, patients now have the option of registering directly online via our website. When it comes to coordinating consultations, we do our best to keep waiting times to a minimum and while ensuring that urgent consultations can be offered at short notice. Dr. med. P. Rippstein Departmental Head

Dr. med. T. Rutishauser Senior Consultant

Dr. med. A. Lanz Senior Consultant

Personnel matters Dr. med. Anette Lanz was made a senior consultant at the start of the year and is therefore in charge of conservative treatment within the Foot and Ankle team. As in previous years, we have bolstered our workforce in response to growing demand: Orthopaedics specialist Dr. med. Sabine Brunner has joined our team in the area of conservative treatment, adding to our expertise with her wealth of experience in treating foot disorders. On the practice management staff, Sandra Meier received extra support from her former deputy Naemi Vögeli. They are now jointly in charge of secretarial duties and scheduling for the Department of Foot and Ankle Surgery. Teaching and lecturing to audiences in Switzerland and abroad When it comes to post-operative care, we continue to emphasise the importance of close cooperation with GPs. The new practice-oriented workshops on common and specific food conditions for colleagues from other disciplines have been well-received. Meanwhile, highly promising test results of a newly developed ankle prosthesis were presented at specialist conferences in Miami and Barcelona. This product is almost ready for the market and is designed to replace a previous prosthesis, also co-developed by Dr. med. Pascal Rippstein, which has already been successfully implanted at Schulthess Clinic more than 600 times. As part of the close partnership between Schulthess Clinic and ETH Zurich, Dr. med. Pascal Rippstein gave a lecture to students at ETH on specific biomechanical foot problems. Members of the Foot and Ankle Surgery team were once again present at significant orthopaedic congresses in 2015. Dr. med. Pascal Rippstein, for example, was invited by the prestigious American Orthopaedic Foot and Ankle Society (AOFAS) to hold a talk on hallux valgus treatments. Dr. med. Jens Mainzer visited four foot surgery centres in Switzerland as part of the Travelling Fellowship programme run by the Swiss Foot and Ankle Society (SFAS), for the purpose of gaining insights into the therapeutic and organisational concepts used by colleagues. Foot and Ankle Surgery in 2015 in figures Staff

Dr. med. P. Binzer Deputy Consultant

To be continued ...

Consultations

24 13 581

Feet operated on

1762

New referrals

2375

37

Technical report: Foot and Ankle Surgery A new way of correcting painful hammer toe deformities

Repairing the plantar plate via a dorsal approach allows for the reconstruction of the anatomy for an optimal

A 53-year-old female patient consulted us about pain in her forefoot during the heel-to-toe motion of the foot. The pain had started a few months previously without any obvious cause and it was getting worse. The patient had experienced repeated problems in connection with many years of hallux valgus. Clinical picture The examination confirmed a typical hallux valgus deformity of moderate severity. This had developed once more following prior hallux surgery performed in another hospital. However, it was also possible to elicit pain by applying pressure to the ball of the foot, with the precise location being underneath the metatarsophalangeal joint of the second toe. In terms of position and mobility, the toe revealed no abnormalities. Given the patient’s obvious level of suffering, surgical treatment of the hallux valgus was indicated, together with the shortening of the second metatarsal bone in order to reduce the excessive strain there. A few weeks before the surgery was scheduled to take place, the patient returned to the Clinic. The position of the second toe had altered dramatically within just a few days with a considerable increase in pain. There was now a new deformity of the second toe known as “cross-over 2nd toe”, a condition in which the second toe crosses over to lie on top of the big toe.

Fig. 1

38

Fig. 2

Foot and Ankle Surgery

surgical outcome.

Background to the problem The reason behind the deformity of the second toe, which had developed within a short space of time, was a tear in the plantar plate. According to recent biomechanical studies, the plantar plate is the most important structure for stabilising the metatarsophalangeal joints. It is a functionally complex connective tissue structure that strengthens the joint capsule underneath the metatarsophalangeal toe joints. Dr. med. C. Hausmann Deputy Consultant

The hallux valgus deformity means that the first metatarsal bone is evaded during the heel-to-toe movement of the foot. This results in painful overloading of the metatarsophalangeal joint of the second toe, a phenomenon known as transfer metatarsalgia. The relative excess length of the second metatarsal bone exacerbates this effect. In the case of this patient, the mechanical overloading had led to the plantar plate gradually becoming thinner, complete with the associated pain, and it had subsequently torn. This marked the beginning of a hammer or claw toe deformity. Since the tear started at the outside, this resulted in the abnormal crossing of the second toe over the big toe.

Dr. med. J. Mainzer Deputy Consultant

Surgical procedure and outcome The planned operation, which now also included the repair of the plantar plate, was performed two weeks after the diagnosis of the crossover deformity. Due to the position of the plantar plate underneath the joints in the loading zone of the ball of the foot, repairing it directly posed a technical challenge for a long time. Scars in this region generally cause problems and often lead to persistent symptoms. However, it is now possible to perform a direct repair from above, approaching the plate through the metatarsophalangeal joints.

Dr. med. C. Otte Deputy Consultant (conservative)

Fig. 1 Cross-over 2nd toe, preoperative

Four weeks after the operation, the patient was able to stop using a special shoe to avoid any pressure on the forefoot and wear normal footwear once more. One year after the surgery, the patient is walking without any pain and the position of the toes has not changed since the operation. Author: Dr. med. Jens Mainzer, Deputy Consultant, Foot and Ankle Surgery

Fig. 2 Once year after the operation; good position and tolerance to loading

39

Spine Surgery and Neurosurgery

Annual Report Spine Surgery and Neurosurgery Heading into the future with proven expertise and new capacity The building extensions, a good reputation as a reference centre, and scientific excellence brought further growth to the department in 2015.

Dr. med. D. Jeszenszky Departmental Head Spine Surgery

Building expansion spurs positive developments The Department of Spine Surgery and Neurosurgery can look back on another successful year, with 2015 being marked by significant changes to the clinic’s premises. The fact that we managed to continue operating to our full potential in spite of the ongoing construction work is down to the excellent coordination of the building committee. The building extension provided additional capacity, thus paving the way for more efficient care and better comfort for patients – thanks to new treatment rooms and operating theatres in the inpatient area and new infiltration and consultation rooms for outpatient activities. The trend towards increasingly complex interventions and operations carried out on patients from Switzerland and abroad, some of whom have undergone several previous operations, is showing no signs of abating and is helping to cement our reputation as a reference centre for spine surgery beyond Swiss borders.

PD Dr. med. F. Porchet Departmental Head Spinal Neurosurgery

Our expertise in spine surgery is focused primarily on complex revision operations, severe deformities in both children and adults, intra- and extradural tumour surgery and, increasingly, minimally invasive interventions. The department’s standard care portfolio also covers treatment for common degenerative conditions of the cervical and lumbar spine (e. g. prolapsed discs), relieving strain on narrowed spinal canals and stabilisation surgery. We carry out a complete follow-up evaluation of all surgery patients using tried-and-tested, scientifically validated monitoring tools to obtain detailed insights into how satisfied patients are with our care. This is an area in which we are leading the way even at an international level. As Switzerland’s largest “spine unit”, and one in which orthopaedic surgeons and neurosurgeons work closely with the Neurology department and other in-house specialist areas, we are also living up to the demands of a multidisciplinary clinic.

Dr. med. F. Kleinstück Senior Consultant Spine Surgery

Dr. med. T. Fekete Senior Consultant Spine Surgery

To be continued ...

Growth in inpatient and outpatient activities The Spine Surgery department’s practice centre recorded a total of 19 112 consultations in 2015, almost five percent more than in the previous year. These included first consultations, postoperative follow-ups, infiltrations, referrals for second or third opinions and assessments for expert reports. In our consultations, we work extremely closely with the related disciplines of neurology and rheumatology and emphasise the importance of interdisciplinary investigations, with procedures such as diagnostic infiltrations playing a key role. Our practice managers and secretarial staff provide proficient support when it comes to coordinating our consultation activities. In terms of inpatient care, a total of 4353 individual interventions were performed on 1317 patients in the course of 1429 operations in the year under review. This represents a 13 percent gain in patient numbers compared to the previous year. We saw a particularly sharp rise in complex spine operations due to an increase in referrals. We also expanded our activities in the areas of spinal tumour surgery, spinal deformities and minimally invasive procedures for degenerative

41

Personnel matters, advanced training and education In the past year, we have welcomed Dr. med. Migena Isaj on board as a highly capable successor to our long-serving ward physician Dr. med. Thorsten Werkhausen. Our team has also been boosted by the addition of a new deputy consultant and neurosurgery specialist, Dr. med. Martin Sailer. In an effort to promote up-and-coming surgical talent, we provided spine surgery training for the following young colleagues during the year under review: Dr. med. Sina Tok, Dr. med. Roman Schwizer, Dr. med. Nils Ulrich, Dr. med. Peter Obid and Dr. med. Matthias Spalteholz. The traditional regular GP symposia rounded off our advanced professional training programme. Fruitful partnership with ETH In 2015, we once again stepped up our collaboration with Prof. Dr. Stephen Ferguson from the Institute for Biomechanics at ETH Zurich. Several senior members of the Spine Surgery department gave lectures at Schulthess Clinic as part of the newly launched “Clinical Challenges in Musculoskeletal Disorders” course for Master’s students at ETH. Scientific activities In the year under review, we continued our excellent cooperation with the Spine department’s research team under the direction of PD Dr. phil. Anne Mannion. Findings from our ongoing multi-centre studies, the ESSG (European Spine Study Group) study investigating the treatment of spinal curvatures in adults and the LSOS (Lumbar Stenosis Outcome Study) on spinal stenosis, were published and presented at numerous specialist conferences. A new addition in 2015 was the APROPOS research project, which is looking into the appropriateness of various treatment methods for degenerative spondylolisthesis. With a total of 24 articles published in peer-reviewed journals and 23 abstracts presented at scientific conferences, the staff of the Spine Surgery department enjoyed their most productive year to date in terms of scientific output. More details about our department’s scientific activities can be found in the in-depth report by PD Dr. phil. Anne Mannion in the “Teaching, Research and Development” section.

42

Spinal Surgery and Neurosurgery

conditions of the lumbar spine. The clinic’s Department of Internal Medicine, which has boosted its workforce, kindly offers competent support in helping us provide our patients with extensive post-operative care.

Technical report: Spine Surgery and Neurosurgery Osteoporosis fractures of the spine – a growing problem

As life expectancy increases, so too does the risk of suffering from osteoporosis in old age. As a result, osteoporosis and its treatment are increasingly turning into a socioeconomic problem. Early diagnosis is essential if appropriate treatment is to be initiated and serious complications are to be avoided.

H.-J. Becker Deputy Consultant Spinal Neurosurgery

Dr. med. D. Haschtmann Deputy Consultant Spine Surgery

Dr. med. O. Pröbstl Deputy Consultant Spine Surgery

An insidious disease Osteoporosis is a bone disease that affects the supportive skeleton – especially the long tubular bones (femur, radius) and the spine. The gradual breakdown of the parts of the bone that provide stability (spongiosa) is characteristic of osteoporosis and significantly increases the risk of a vertebral body fracture. The World Health Organization (WHO) defines osteoporosis as a deviation from the bone mineral density of a healthy 30-year-old person. In quantitative terms, this deviation is expressed as a T-score. In order to calculate the T-score, bone mineral density is measured by taking an X-ray of the lumbar spine (and sometimes of the hip or wrist too). A T-score is considered normal if it is above − 1. “Minus 1.0” means one standard deviation below optimal bone mineral density and is only just considered normal. If the bone density measurement is more than 2.5 standard deviations below normal, this is classed as osteoporosis. Osteoporosis fractures of the spine: causes and frequency A vertebral body fracture can result from even a trivial trauma or a mild strain, such as a forced cough or lifting a light weight. The most common causes are falls onto the buttocks or bumping into something with one’s back; in some cases it is impossible to pinpoint a specific incident that has led to the fracture. Typical symptoms consist of back pain, which can occur either immediately or within a few days or weeks and which can become more intense over time as the vertebral body becomes more and more compressed. Sometimes, vertebral body fragments press against nerves, leading to dysaesthesia, motor deficits and even paraplegia. A rapid diagnosis of symptoms of this kind is essential. Osteoporosis fractures are common in Switzerland. Each year, around 25 000 people suffer a spinal fracture (310 / 100 000 / year; Federal Office of Public Health, FOPH, 2004). Approximately 10 000 people sustain a femoral fracture each year (FOPH, 2004). The lifetime risk of a 45-year-old woman in Switzerland sustaining a spinal fracture is 21 percent, while the figure for a 45-year-old man is 9 percent (FOPH, 2004). Women are therefore affected by spinal fractures twice as often as men. One of the reasons for this is the hormonal changes a woman experiences during the menopause, as these changes increase the risk of osteoporosis.

Dr. med. M. Sailer Deputy Consultant Spinal Neurosurgery

43

An osteoporotic spinal fracture should always be treated with drugs too. In consultation with the rheumatologists, blood tests are performed to measure the levels of calcium, vitamin D and other factors that are relevant to bone health and these results are often used as the basis for longerterm treatment. In the case of a minor spinal fracture (without nerve deficits) healing can be supported by means of a brace, especially a 3-point brace, which must be worn consistently for at least 6 weeks. Progress is documented both clinically and radiologically. If, despite the treatment with a brace, further compression of the vertebral body occurs or if the pain increases further, surgery to repair the vertebral body must be considered. Equally, a change of treatment is often required because wearing the corset is too onerous. One option for interventional treatment involves cement augmentation of the bone. Two different methods are available: kyphoplasty and vertebroplasty. Both methods involve making two small (five-millimetre) skin incisions on the back and inserting two fine cannulas into the vertebral body. With vertebroplasty, bone cement is injected directly into the fractured vertebral body. This procedure is indicated for older fractures (as a general rule, fractures that are at least 3 months old). However, kyphoplasty is used if the fracture is more recent. With this procedure, a small balloon is inflated inside the vertebral body to restore its height and cement is then used to stabilise it. The affected vertebral body can bear weight again as normal after either vertebroplasty or kyphoplasty, so the patient can stand and walk again immediately. A medical study (meta-analysis) has shown that, for more extensive fractures, cement augmentation delivers better results than treatment with a back brace alone (Anderson et al., Journal of Bone and Mineral Research, 2013). After cement augmentation, back pain in particular recedes quickly, allowing the patient to make a quick return to managing their everyday activities independently once more. Cement augmentation is most commonly used to treat spinal fractures. In the case of a serious spinal fracture with narrowing of the spinal canal or the development of deformities, open stabilisation surgery is required. This may mean replacing a vertebral body with a spacer device and using screws and rods to straighten the distorted part of the spine.

44

Spinal Surgery and Neurosurgery

Diagnosis and treatment When an osteoporotic fracture is suspected, a conventional X-ray of the painful region of the spine is taken in addition to performing a clinical examination. An MRI scan of the spine is then also performed in order to assess the age of the fracture more precisely and to identify and analyse any possible nerve compression. Compared to the investigation of traumatic fractures, CT scans play a less important role in the diagnosis of osteoporotic fractures and these are only performed occasionally.

Conclusion When elderly patients suffer from back pain after a minor trauma, the possibility of an osteoporotic spinal fracture should always be considered. A detailed clinical and radiological diagnostic investigation is followed by individually tailored treatment. Since osteoporosis is a systemic disease of the skeleton, treatment should always take the form of a multidisciplinary approach.

Preoperative

Postoperative L1 fracture

Vertebra stabilised with bone cement

Fig. 1

Fig. 1 Cement augmentation of the first lumbar vertebra to treat an osteoporotic fracture Fig. 2 Schematic representation of the kyphoplasty procedure for the cement augmentation of a fractured vertebra; pictures reproduced with the kind permission of Medtronic Fig. 2

45

Neurology

Annual Report Neurology Sought-after expertise in teaching and practice Neurological diagnostics play an important role in interdisciplinary investigations prior to surgery and during intra-operative monitoring. Patients are the main beneficiaries of our extensive experience in this area, but young specialists in both Switzerland and abroad also take advantage of it.

Dr. med. A. Müller Departmental Head

Dr. med. A. Eggspühler Senior Consultant

Diagnosis before therapy Diagnoses are made based on an analysis of the patient’s symptoms and the findings gained from a detailed examination by the doctor. The syndrome diagnosis derived from this provides the basis for verifying the cause through additional investigations. Even normal results or non-pathological abnormalities are factored into the diagnosis. Ideally, the symptoms and individual findings will all add up to a single, clear diagnosis. This ideal scenario is more likely to occur in the case of younger patients than older ones. Concomitant diseases become more common with age, posing an increasing challenge for the doctor tasked with classifying the various symptoms and findings. Concomitant diseases or comorbidities is the term used to describe the presence of several disorders at the same time and it is often very difficult to distinguish between the symptoms and findings specific to each one. Thanks to the close cooperation between the surgical and conservative disciplines (neurology, rheumatology, sports medicine and internal medicine) at Schulthess Clinic, we are able to make differentiated diagnoses. This is crucial to predicting the likelihood of a successful surgical outcome as reliably as possible when making a decision on whether or not to operate. The wealth of diagnostic and therapeutic expertise and experience we offer as neurologists plays a significant role in ensuring that patients receive the best possible care. Teaching at the University of Zurich, ZHAW, ETH and internationally University of Zurich: A course on neurological investigation, held at our clinic, forms part of the firstyear Master’s programme for medical students. Senior consultants Dr. med. Martin Sutter and Dr. med. Andreas Eggspühler fulfil this teaching assignment on behalf of Schulthess Clinic’s Neurology department. F-MARC programmes: Prof. Dr. med. Jiří Dvořák is the global representative for the F-MARC programmes. In addition, he undertakes national and particularly international lectureships.

Dr. med. M. Sutter Senior Consultant

ZHAW (Zurich University of Applied Sciences): Dr. med. Alfred Müller held lectures on neurology as part of the Master’s course in Physiotherapy in 2015. D-HEST (Department of Health Sciences and Technology) at ETH Zurich: In 2015, a demonstration week was held for first-year students for the second time, including numerous presentations and practical courses on the subject of clinical research. Lectures were also run at Schulthess Clinic as part of the Health Sciences Master’s programme for the first time, with Prof. Dr. med. Jiří Dvořák and Dr. med. Alfred Müller giving talks on “Clinical Challenges in Musculoskeletal Disorders”.

To be continued ...

47

Consultant Dr. med. Georg Egli established himself as Head of the Department for Medico-Legal Affairs. As a senior consultant, Prof. Dr. med. Bogdan Radanov continued to be available for expert opinions in 2015. MIOM Multimodal intra-operative monitoring (MIOM) permits continuous monitoring of the function of nerve pathways from the central nervous system to the effector organs during surgery. This makes it possible to intervene at an early stage if any dysfunctions occur during the operation and to check the procedural steps with the surgeon before any lasting damage is inflicted. In 2015, multimodal intra-operative monitoring of the nervous system was required in 563 operations. Thanks to the experience gained from 15 years of excellent cooperation between surgeons and neurologists, we have been able to go to limits during difficult interventions that would have been unthinkable only a short while ago, without running the risk of causing lasting damage.

48

Neurology

Neurology team in 2015 In 2015, the Neurology team consisted of Departmental Head Dr. med. Alfred Müller, Senior Consultant Prof. Dr. med. Jiří Dvořák, Senior Consultant MIOM Dr. med. Martin Sutter, Senior Consultant in Electrophysiology Dr. med. Andreas Eggspühler, Consultants Dr. med. Oliver Häussler and Dr. med. Christian Lanz, and Deputy Consultant Dr. med. Ute Kretzschmar. The team was complemented by three neurology assistants. Dr. med. Sonja Tartarotti was promoted to deputy consultant at the start of July 2015.

The Swiss Concussion Center (SCCC) Schulthess Clinic’s Department of Neurology boasts well over 20 years of experience in dealing with concussion, particularly in connection with sporting injuries. The Swiss Concussion Center was set up in 2015 on the back of the partnership between Schulthess Clinic and the Interdisciplinary Center for Vertigo and Balance Disorders and the Department of Neurology at University Hospital Zurich. (Details can be found on pages 52 and 53.) Prof. Dr. med. J. Dvořák Doctor / Senior Consultant

Facts and figures The overview table below summarises the outpatient activity of our department. In the late summer of 2015, additional space was made available for the Neurology department to move into as work on the building extension was completed. As before, approximately 40 percent of patients are referred to us by independent colleagues practising in the Greater Zurich region, the neighbouring cantons, but also from all over Switzerland. We also have diagnostic and occasionally therapeutic responsibility for a few dozen patients mainly from elsewhere in Europe, with some now coming from further afield.

Dr. med. C. Lanz Consultant

2009

2010

2011

2012

2013

2014

2015

7144

6998

7253

7001

6987

6246

6367

61

41

23

23

21

36

19

3969

3888

3625

3714

3881

3694

3708

1.8

1.8

2.0

1.9

1.8

1.7

1.7

Reports to patients / doctors and insurance companies

7893

7703

6200

6800

7242

7313

7786

Neurological examinations

3967

4450

4846

4400

4369

4220

4225

EMG, ENG, SEP, MEP

2644

2976

2676

2500

2762

2803

2919

MIOM

320

329

376

428

500

551

563

Ultrasound of afferent cerebral vessels and peripheral nerves

425

385

270

285

302

284

393

2851

3168

3551

3800

4245

4320

4530

Total consultations Expert reports Number of patients Ø consultations per patient Dr. med. O. Häussler Consultant

Dr. med. G. Egli Consultant

To be continued ...

Diagnostic and therapeutic infiltrations at the spine with image amplification

49

Technical report: Neurology Nerve cysts – a rare cause of nerve damage

Painful paralysis of the dorsiflexion of the foot and toes without the typical deficit pattern associated with nerve root L5 may be the result of peroneal nerve compression damage due to cysts. A differential investigation at the

A 54-year-old male patient was referred to our Clinic for a second opinion. The patient was suffering from persistent and severe paralysis of the dorsiflexion of the foot with nerve pain in the left lower leg and foot, despite surgical exposure of the left L5 nerve root in September 2013. Case history The symptoms started after a cycling tour in August 2013 with pain in the left lower leg and foot instep. Paralysis of the dorsiflexion of the foot quickly followed. Since the suspected diagnosis was a herniated disc with pressure on nerve root L5 on the left, surgery was performed at another hospital on 6 September 2013, but this failed to bring about any significant improvement. Diagnostic investigation The neurological examination on 11 April 2014 revealed persistent, severe and almost complete paralysis of the dorsiflexion of the left foot and toes. In the case of a deficit of nerve root L5, the middle gluteal muscle (gluteus medius) is usually also weaker than normal and this is associated with pelvic instability (Trendelenburg test). This was not, however, the case with this patient. The outer side of the front of the lower leg and the foot instep were numb. The left peroneal nerve was painful to pressure in the region of the head of the fibula, complete with electrifying sensations extending into the foot (Tinel’s sign). Electrophysiology nerve conduction and needle tests of the leg muscles revealed severe damage to the peroneal nerve in the left leg. The MRI scan of the lumbar spine which was performed on 24 December 2013 did not reveal any impairment of nerve root L5 on the left. Since damage to the left peroneal nerve was suspected, an MRI scan of the left lower leg was performed on 16 May 2014. This revealed that cysts (known as intraneural ganglion cysts) were infiltrating an extended stretch of the peroneal nerve in the region of the knee joint.

Peroneal nerve with cysts

Fig. 1

50

Peroneal nerve with cysts

Fig. 2

Neurology

right time and the correct diagnosis are of critical importance.

Intraneural ganglion cysts are a very rare cause of nerve injuries and predominantly affect the peroneal nerve. The cysts form as a result of a capsular injury at the tibiofibular joint and make their way along a small articular nerve to the main nerve. From there, they can spread to the sciatic nerve and into the tibial nerve and cause nerve damage by exerting pressure.

Dr. med. U. Kretzschmar Deputy Consultant

Treatment and subsequent development The treatment of choice is a neurosurgery procedure to sever the articular nerve and drain the cysts that are exerting pressure. This operation was performed at Schulthess Clinic on 14 August 2014 by Dr Schindele (specialist in hand surgery and neurosurgery). Follow-up examinations (the last of which was in January 2016) showed a partial improvement in the nerve pain, but not in the paralysis. Unfortunately, the long-term pressure exerted on the nerve by the cysts has caused irreversible damage. Conclusion When a patient presents with painful paralysis of the dorsiflexion of the foot and toes without the typical damage pattern associated with an L5 nerve root syndrome, the possibility of damage to the peroneal nerve due to intraneural ganglion cysts must always be considered.

Dr. med. E. Scherer Deputy Consultant

Author: Dr. med. Christian Lanz, Consultant, Neurology

Fig. 1 Longitudinal section of the peroneal nerve with cysts Fig. 2 Peroneal nerve with cysts, cross-section just below the knee joint

Peroneal nerve Peroneal nerve

Fig. 3 Peroneal nerve at the head of the fibula Fig. 4 Cysts in the peroneal nerve

Tibiofibular joint capsule

Articular nerve Fibula

Cysts inside the nerve

Tibia Fig. 3

Fig. 4

51

The Swiss Concussion Center A centre of excellence for concussion in competitive sport

The Swiss Concussion Center is affiliated with the Wilhelm Schulthess Foundation and serves as an international centre of excellence for concussion in competitive athletes from all kinds of different sports. Its activities cover clinical practice, research and the provision of services, and it is underpinned by a team of selected specialists with

The Swiss Concussion Center The Swiss Concussion Center (SCC) was founded in mid-September 2015 by Schulthess Clinic in collaboration with doctors from the Department of Neurology and the Interdisciplinary Center for Vertigo and Balance Disorders at University Hospital Zurich and the University of Zurich, and since then it has been systematically developed. The SCC is supported by the Wilhelm Schulthess Foundation. The aim of the SCC is to improve the management of sport-related concussion in competitive athletes. The centre covers three core areas: clinical practice, research and services. Clinical practice involves providing care for competitive athletes from a range of different sports who have experienced concussion, while the research area deals with questions surrounding the management of sport-related concussion, and the services provided include carrying out basic tests to collect specific baseline data for associations, clubs and individual athletes and offering training for specialist staff involved in sport. More than 40 competitive athletes had been treated at the centre by the end of 2015 (75 percent men, 25 percent women). These patients spanned seven different sports (ice hockey, football, handball, equestrian sport, Swiss wrestling, motor racing and cycling), with most referrals coming from ice hockey. Team The SCC team is made up of carefully selected specialists with many years of experience in their chosen area of expertise and close links with competitive sport. There were 18 specialists working at the centre as of the end of the year under review. Diagnostic services The SCC uses the latest instrument-based examination and measuring methods to pinpoint and quantify functional or structural abnormalities following concussion as precisely as possible. In addition to a clinical neurological examination and an examination of the cervical spine, the SCC offers instrument-based vestibular and oculomotor testing, a neuropsychological investigation, an SCC physio check and dynamic posturography (Equitest). The tests are chosen on the basis of the findings from the clinical examination. Instrument-based vestibular and oculomotor testing Dizziness and balance disorders are some of the most common symptoms that arise after a head injury. The instrument-based vestibular and oculomotor investigation process comprises a range of standard tests designed to check the balance functions of the inner ear and the brain (Fig. 1). It took almost six months to set up and install the extremely comprehensive battery of tests involved. The following tests have been carried out at the SCC since the start of October: video head impulse tests (visual stabilisation during rapid head movements), dynamic visual acuity tests (sharpness of vision during head movements), saccular tests (measurement of neck muscle activity during acoustic stimulation of the inner ear), utricular tests (measurement of eye muscle activity during vibration of the head), video-oculography with caloric testing (recording voluntary and involuntary eye movements under various conditions) and fundus photography (degree of eye roll).

52

The Swiss Concussion Center

many years of experience in their chosen field and close links with competitive sport.

Dynamic posturography (Equitest) The dynamic posturography (Equitest) procedure is based on a dynamic analysis of the components involved in the balance system (Fig. 2). This makes it possible to differentiate between impairments in vestibular or visual perception and somatosensory disturbances following a head trauma. This method can also be used to test motor control. Impairments are recorded on a quantitative basis and can be monitored during the rehabilitation period. SCC physio check The SCC physio check involves taking a brief medical history, conducting a vestibulo-oculomotor evaluation, checking postural stability, carrying out a gait analysis, specifically examining the cervical spine and performing various functional tests (cardiovascular functions, coordination skills and sport-specific skills). Based on the results and in consultation with the doctors responsible for the athlete’s treatment and the medical care team, a tailored rehabilitation programme is drawn up according to the athlete’s individual needs.

Dr. med. N. Feddermann-Demont Specialist in Neurology Head of the SCC

Dr. phil. M. Bizzini, PhD Head of Physiotherapy, SCC

Therapy Depending on the diagnosis, initiating and implementing optimum therapeutic measures following concussion is essential for enabling athletes to return to routine training and competitive sport as quickly and as safely as possible. Therapy options are suggested on the basis of each athlete’s requirements and framework conditions. The main therapeutic areas covered are physiotherapy, dynamic posturography (Equitest), therapy using special swivel chairs and pain therapy. Research In addition to preventing concussion and offering immediate pitch-side screening, one of the SCC’s primary concerns is providing the best possible medical care for athletes following a head trauma. Due to the different implications they have in terms of treatment, the main diagnostic priority in the case of a head trauma is to distinguish between primarily central functional disorders (concussion or brain injury) and peripheral disorders in the area of the equilibrium organ in the inner ear (inner ear trauma or injury) or the cervical spine. Basic testing carried out during the pre-season period also helps to detect minor abnormalities that athletes would not have noticed during their everyday activities. Moreover, even normal findings following concussion can have a pathological significance with regard to practising a particular sport. With this in mind, the SCC is involved in developing and compiling an optimised battery of tests for athletes to analyse the various systems as objectively as possible with a view to ensuring a speedy and safe return to sport. Other areas of research focus on the much-discussed long-term consequences of (repeated) concussions.

Fig. 1 Instrument-based vestibular and oculomotor testing Fig. 2 Dynamic posturography Fig. 1

Fig. 2

53

Paediatric and Adolescent Orthopaedics & Deformity Correction

Annual Report Paediatric & Adolescent Orthopaedics and Deformity Correction Proven expertise under a new name 2015 provided our department with the opportunity for the expansion we needed – in terms of both premises and personnel – in order to cope with the continued rise in patient numbers.

Key changes and developments Last year saw the Paediatric Orthopaedics department become the Department of Paediatric and Adolescent Orthopaedics and Deformity Correction. This change of name takes into account the fact that we are increasingly providing treatment and extremity reconstructions with or without external fixation for complex deformities in adults too.

Dr. med. R. Velasco Departmental Head

Thanks to the new building extension, our department now boasts five spacious doctor’s offices, two secretary’s offices and a large waiting area for patients both young and old. We also have a new multifunctional room for changing dressings, applying plaster casts and carrying out diagnostic hip ultrasound scans. Since May 2015, our team has been boosted by the addition of Deputy Consultant Dr. med. Matthias Tedeus, who provides support for both conservative and surgical treatment. He has a wealth of experience to offer from several years of training in paediatric orthopaedics in Berlin, Munich and, most recently, Winterthur.

Dr. med. H. Manner Senior Consultant

Dr. med. S. Willi-Dähn Deputy Consultant

In the area of bone lengthening, we successfully implanted the first magnetically controlled intramedullary nail extensions in 2015. Compared to conventional extension methods with external fixation, this procedure puts significantly less strain on patients. The results have been extremely promising so far. However, an accurate diagnosis and a precise pre-operative analysis are essential for ensuring the best possible final outcome. Proven interdisciplinary cooperation Aside from our own specialist paediatric and adolescent orthopaedic activities, working with colleagues from other disciplines plays an important role in our work. The invaluable and often readily available expertise they offer ensures that we can provide top-quality treatment even in exceptional cases, such as those involving joint-specific problems that extend beyond the spectrum of paediatric orthopaedics. Another key aspect is the contribution of the paediatric anaesthesia team, led by PD Dr. med. Christian Keller and Dr. med. Madeleine Niederer. Their careful way of dealing with children and extremely efficient working methods are appreciated not just by us, but most importantly of all by our young patients and their parents.

Dr. med. M. P. Tedeus Deputy Consultant

55

The steady rise in patients is reflected in the increasing number of operations being carried out. Thanks to our expanded surgical capacity, we are able to meet this greater demand while continuing to offer surgical treatment at short notice. This will enable us to carry on fulfilling the needs of the children we treat as effectively as possible in future, always taking their social environment into account. We consider ourselves lucky to be able to provide high-quality orthopaedic services for children and adolescents here at Schulthess Clinic that meet the standards of our patients, the doctors who refer them and, last but not least, us as paediatric orthopaedists. Facts and figures for Paediatric and Adolescent Orthopaedics and Deformity Correction

56

2011

2012

2013

2014

2015

Outpatient operations

116

117

121

118

110

Inpatient operations

215

210

190

210

260

Total (individual interventions)

331

327

311 328 (636)

370 (710)

Paediatric and Adolescent Or thopaedics & Deformity Correction

Our departmental performance in figures The statistical analysis for 2015 shows very encouraging growth for us in terms of both outpatient services and inpatient surgical treatment.

Technical report: Paediatric and Adolescent Orthopaedics & Deformity Correction Elbow injuries during childhood Fractures in the elbow region are a common injury in children and adolescents and, as a general rule, they respond well to primary treatment. However, time and again we see post-traumatic elbow deformities in our Clinic, some of which could have been avoided with the right primary diagnosis and treatment. Nevertheless, as our examples show, even these deformities can often be corrected with the help of complex treatment methods.

Fig. 1–6 A multidimensional deformity is corrected with the help of an external fixator.

Deformity after a supracondylar humerus fracture Supracondylar humerus fractures are one of the most common injuries and they are treated by means of an open or closed reduction, depending on the degree of displacement. Achieving the ideal reduction and stabilisation is often difficult. The fracture is usually fixed using crossed wires and plaster, but it is not unusual for patients to be left with a residual deformity. As a general rule, the distal fragment is rotated inwards and tilted in a varus position, resulting in a multidimensional deformity. It is almost impossible for this to resolve itself over time and it leads to partial impaired functioning of the elbow, usually in relation to flexion or hyperextension. This varus deformity can also be very upsetting at a cosmetic level. In such cases, a corrective osteotomy should be considered. The fixation can either be performed internally or, for reasons of precision, can be controlled externally with the fixator. The latter method is preferable, especially in the case of more complex, multidimensional deformities and younger children (Fig. 1–6). Case study figures 1–6 A supracondylar humerus fracture with extreme displacement resulted in a varus and internal rotation deformity associated with substantially restricted mobility (flexion), especially due to the ventral protrusion (shown by arrow). This was corrected by means of a derotation anti-varus osteotomy with an external fixator, which was removed after two months.

Fig. 1

Fig. 2

Fig. 3

Fig. 4

Fig. 5

Fig. 6

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Fig. 8

Fig. 9

Intra-articular fractures that go unnoticed Some of the most severe post-traumatic deformities arise after intra-articular fractures that have not been noticed, both with and without secondary growth plate involvement. These fractures not infrequently occur as part of a dislocation of the elbow. Although these dislocations can usually be easily treated through closed reduction, it is essential to rule out concomitant injuries, preferably by means of a CT or MRI scan. Although displaced epicondylar fractures that are not diagnosed in the first instance can fortunately still be treated relatively successfully at a later stage (Fig. 7–10), transcondylar fractures that do not receive the correct treatment often result in extreme deformities with considerable limitations of movement due to growth plate involvement or intra-articular displacement. In such cases, it is almost impossible to achieve a satisfactory reconstruction (Fig. 11–13), meaning that the only remaining option is what are known as “salvage” procedures, which generally produce disappointing results. Case study figures 7–10 Five weeks after the elbow joint was dislocated, there is a persistent and complete restriction of its mobility. Further investigation using CT revealed that the lateral epicondyle was trapped within the joint. This was subsequently treated by means of an open reduction and fixation with a screw and wire. Case study figures 11–13 In the case of this boy, a complex intra-articular fracture was not diagnosed and was therefore not treated. The result was a catastrophic deformity with pronounced restriction of movement. Therapeutic options are very limited here.

Fig. 11

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Fig. 12

Fig. 13

Fig. 10

Paediatric and Adolescent Or thopaedics & Deformity Correction

Fig. 7

Fig. 14

Fig. 15

Fig. 16

Radial head and neck fractures Another typical elbow injury is a radial head or neck fracture. While displaced or multifragmentary radial head fractures generally have to be reduced using open methods, radial neck fractures should be treated conservatively where possible or reduced using closed methods (Fig. 14 –16). Case study figures 14–16 This girl fell off a horse and sustained an elbow subluxation, causing a very tilted radial neck fracture and olecranon fracture. Fortunately, it was possible to reduce the fracture by a closed method through use of a special reduction manoeuvre and to secure it with a plaster cast. An isolated dislocation of the radial head is observed relatively rarely as a post-traumatic injury, but it can occur in association with a fracture of the ulna (known as a Monteggia fracture). If the injury is already chronic, it is almost impossible to keep the radial head in the reduced position. In isolated cases, a closed reduction needs to be performed using a circular fixator (Taylor Spatial Frame) (Fig. 17–20).

Fig. 7–10 Open reduction of a displaced medial epicondyle fracture following a dislocation of the elbow

Case study figures 17–20 An undetected dislocation of the radial head in an anterior direction occurred in association with an ulnar fracture. After several unsuccessful attempts at reduction, a closed reduction of the radial head in stages using the Taylor Spatial Frame finally succeeded, with gradual extension and flexion of the ulna.

Fig. 11–13 Severe, irreversible deformity following a non-diagnosed fracture in the early growth phase Fig. 14 –16 Closed reduction of a very severely tilted fracture of the radius

Fig. 17

Fig. 18

Fig. 19

Fig. 17–20 Stage-by-stage reduction of a long-term dislocated radial head with the help of the Taylor Spatial Frame. Fig. 20

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Anaesthesiology

Annual Report Anaesthesiology Pain treatment begins before the operation is even over Severe pain after surgery not only has a negative impact on a patient’s general well-being – it can also hamper and delay the healing process. Pain management is therefore a key concern for all doctors and nurses providing treatment and care at Schulthess Clinic.

Pain usually has a clear function to perform: it warns the body of dangers by sending out signals via complex connections in the spinal column and the brain. Pulling your hand away when you touch something hot is an example of your body’s natural reaction to the warning signal that the object in question is “too hot”. This is intended to protect you from harmful burns.

PD Dr. med. C. Keller M. Sc. Departmental Head

However, patients do not necessarily expect surgical pain – it is induced artificially and does not serve to send out a warning. These days, pain treatment is initiated while operations are still underway to minimise stress for patients. Blocking post-operative pain can also have a beneficial effect on the healing process. Schulthess Clinic’s “Pain Service” The Department of Anaesthesiology at Schulthess Clinic provides a special “Pain Service” to deal with pain management. The Pain Service team consists of a “pain doctor” (i. e. a specially trained anaesthetist) and various “pain nurses” (experienced nurse anaesthetists). The four pillars of pain treatment Good pain treatment is based on four main pillars.

Dr. med. S. Bazzigher Senior Consultant

First of all, it prevents pain from having a negative impact on cardiovascular and lung function and the gastrointestinal tract. Secondly, it prevents the body’s immune system from being weakened due to pain. Thirdly, it facilitates effective breathing therapy and physiotherapy exercises, which play a key role in ensuring a rapid recovery. And finally, it enables quicker mobilisation (sitting up, standing up, walking).

Dr. med. M. Niederer Senior Consultant

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Patient-controlled analgesia On the wards, there is pain medication available that can be administered at regular intervals in the form of a tablet, suppository or injection as required. If an infusion is set up, medication can also be supplied directly into the bloodstream. One particularly cutting-edge and effective treatment method available to the anaesthetists in the Pain Service team for controlling severe pain after major operations is what is known as patient-controlled analgesia (PCA). This involves connecting special mobile infusion pumps to either a pain catheter or an intravenous catheter. The intravenous option enables patients to release a certain dose of analgesic at predefined intervals by pressing a switch. Pain Service staff visit the patients on a daily basis to monitor the success of the treatment. If necessary, they adjust the dose of the medication provided to suit individual requirements. Patients are also asked whether they have experienced any side effects, such as problems emptying their bladder, nausea, itchiness or numbness. These side effects can usually be treated effectively.

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Anaesthesiology

Encouraging patients to keep a record of their pain To enable the Pain Service team to observe the success of pain treatment over an extended period and to assess and gain a better understanding of the severity of the pain as it is subjectively perceived by patients, patients are asked to measure their pain, preferably several times a day, and to keep a record of it. To do this, patients can use a special pain scale – also known as a visual analogue scale (VAS) – to rate the intensity of the pain they feel on a scale of zero to ten. Zero means “no pain”, while a rating of ten indicates “the strongest pain imaginable or unbearable pain”.

Intensity of post-operative pain after various operations without adequate pain treatment: At rest

During movement

Breast surgery

10 – 30 *

20 – 35 *

Hernia

15 – 25 *

25 – 35 *

Total hip replacement

25 – 30 *

40 – 50 *

Thoracotomy

45 – 65 *

60 –70 *

Gastrectomy

50 – 75 *

60 –70 *

Total knee replacement

55 – 65 *

75 – 85 *

* Percentage of patients who have severe pain with a VAS rating > 7 0 = no pain; 10 = strongest pain imaginable and /or unbearable pain

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Rheumatology and Rehabilitation

Annual Report Rheumatology and Rehabilitation A central interface for interdisciplinary diagnosis and treatment Disorders of the musculoskeletal system require a comprehensive, multi-stage diagnosis and well-coordinated conservative and rehabilitative treatment, often on an interdisciplinary basis. The activities of the Department of Rheumatology and Rehabilitation range from providing individual long-term care and assistance with making decisions on surgical treatment through to providing expert opinions.

Rheumatology team The depletion of our medical team meant that the number of patients treated dropped slightly in 2015 compared to previous years (2506). Unfortunately, this gave rise to longer waiting times, for which we sincerely apologise to all our patients and referring doctors.

Dr. med. I. Kramers-de Quervain Departmental Head

Towards the end of the year, Dr. med. Anna Thoma, a specialist in rheumatology, physical medicine and rehabilitation with a sub-specialism in osteology, was appointed as senior consultant. She is also serving as deputy to the departmental head, Dr. med. Inès Kramers-de Quervain. We would like to offer her our sincere congratulations on this promotion. Senior Consultant Dr. med. Jürg Oswald, a specialist in rheumatology, remains in charge of the Musculoskeletal Ultrasound department. As of this year, Consultant Dr. med. Ralph Ringer has been involved in the ultrasound team in addition to his rheumatology activities. Doctors undergoing further training were Dr. med. Alex Wagner and Dr. med. Johannes Schunk. The medical team is supported by Practice Manager Karin Hürlimann and her competent and highly dedicated medical practice assistants and secretaries Evelyn Khadra, Corina Monitz, Gamze Ter, Lydia Wanner and Manuela Weber.

Dr. med. J. Oswald Senior Consultant

The Rheumatology and Rehabilitation team Dr. med. A. Thoma Senior Consultant

Dr. med. R. Ringer Consultant

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Osteoarthritis treatment The Rheumatology team is responsible for providing conservative – i. e. non-surgical – treatment for osteoarthritis in both large and small joints with the aim of relieving pain and improving functionality. This is done by means of individually tailored courses of physiotherapy. In many cases, pain can be relieved with injection treatment, using steroid injections combined with hyaluronic acid products (viscosupplementation) as well as autologous blood processes (Orthokine, ACP). Analgesic and anti-inflammatory drugs are prescribed as required and patients are given advice on physical activity, sport and any adjustments needed in their job. Arthritis treatment Inflammatory-rheumatic conditions include rheumatoid arthritis, axial and peripheral spondyloarthropathy, psoriasis arthropathy and reactive arthritis, as well as various undifferentiated, nonclassifiable arthritic disorders. Crystal diseases such as gout (uric acid) and pseudogout (calcium pyrophosphate) can also trigger inflammatory attacks. Conventional basic drugs and modern biologics are used to control the inflammatory immunological event. Acute inflammatory attacks can often be relieved by injections into the affected joint. Physiotherapy and occupational therapy play an important role in preserving joint function and patients’ independence. Osteoporosis treatment Comprehensive diagnoses – using equipment including a state-of-the-art DXA device – and targeted treatment are carried out with the aim of improving bone quality and preventing fractures by reducing the risk of falling. This is done with the help of appropriate medication and specifically adapted physiotherapy programmes.

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Rheumatology and Rehabilitation

A focus on diagnosis One of the key tasks of the Department of Rheumatology and Rehabilitation is to carry out diagnostic investigations based on patients’ complaints. This is done by means of targeted patient interviews and clinical examinations. Laboratory analyses and instrument-based procedures such as X-rays, ultrasounds, MRI and CT scans, scintigraphy and bone mineral density measurements are also carried out as required. If necessary, a synovial fluid analysis can also be performed to investigate whether swollen joints are due to a mechanical-degenerative or an inflammatory-rheumatic condition. This comprehensive assessment gradually builds up a clear picture of whether the patient’s symptoms can be attributed to an inflammatory-rheumatic problem or a non-articular rheumatic condition (muscles, tendons), to degenerative changes in the joints (osteoarthritis) or the spine or to functional disorders of the musculoskeletal system. An evaluation of the relevant functional impairments and their impact on everyday life, leisure activities and work is also a key factor in choosing the right treatment.

Patients are increasingly being referred to us before undergoing orthopaedic or spine surgery in the surgical departments so that we can assess their bone quality and provide targeted treatment before their operations as required. Treatment of spinal disorders Working closely with the Department of Physiotherapy, our focus here is on rehabilitative measures, although injection procedures and manual medicine treatments are also carried out as required. We also cooperate intensively with the Spine Surgery, Neurology and Manual Medicine departments to ensure that patients receive comprehensive, interdisciplinary advice. Interdisciplinary cooperation – a top priority at Schulthess Clinic Sometimes, long-term conservative rheumatological treatment for patients with degenerativemechanical or inflammatory-rheumatic disorders reaches its limits and surgical options have to be considered. In these cases, close interdisciplinary cooperation with orthopaedic surgeons makes it easier to come to a decision. Rheumatologists assist with patient care before and after operations as “musculoskeletal system generalists”. If several joints or parts of the body are affected, they help to set therapeutic priorities and coordinate treatment. Expert reports In collaboration with the Department for Medico-Legal Affairs, our rheumatologists and rehabilitation specialists are involved in preparing interdisciplinary expert reports, as well as individual expert reports for insurance companies or for assessing patients’ fitness for work. The Rheumatology team produced 26 expert reports in 2015. Our department’s main task in this regard is to carry out functional capacity evaluations (FCE). The FCE therapist responsible for this is freelance occupational therapist Stephan Staffelbach, whose practice was successfully audited and certified as an FCE institution in 2015. He is supported by Dirk Schmidt from the Department of Physiotherapy. As part of his freelance activities, Stephan Staffelbach also conducts workplace assessments. Activities in professional bodies Dr. Inès Kramers-de Quervain is President of the Swiss Society for Physical Medicine and Rehabilitation (SGPMR) and serves on the governing body of Zurich rheumatologists. 

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Technical report: Rheumatology and Rehabilitation “Reactive” ankylosing spondylitis

An unusual case demonstrates how a comprehensive and differentiated diagnostic investigation can help with

The 38-year-old man, who had no pre-existing conditions, was referred by the Department of Lower Extremity Orthopaedics following the spontaneous onset of joint effusion in the left knee six weeks previously. Comprehensive diagnosis procedure The cell count of 5750 / µl in the synovial fluid pointed to an infection, but no bacteria or crystals were found. The patient denied any previous infection or tick bite. However, the patient reported pain in the spine and buttocks at night which improved on movement. The patient had no symptoms relating to other organ systems. There was nothing of note in the family history. The left knee showed swelling due to effusion, was slightly overheated and its mobility was restricted due to the pain. Other joints, including the vertebral joints, revealed no clinical or radiological abnormalities. The results of the comprehensive blood tests were normal, apart from a positive HLA-B27 result. The HLA-B27 surface protein is associated with the chronic inflammatory condition of the spine of the ankylosing spondylitis type. During the comprehensive investigation, a molecular genetic test (PCR) revealed evidence of the bacterium Chlamydia trachomatis in the patient’s urine – a surprising finding in a patient with no corresponding symptoms. In view of the night-time back pain, we arranged a magnetic resonance imaging (MRI) scan, which revealed inflammatory changes in the sacroiliac joints and thoracic spine. The MRI scan also confirmed the presence of an inflammatory process in the knee with effusion and synovitis (inflammation of the joint capsule). A spondyloarthropathy (ankylosing spondylitis) was diagnosed.

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Rheumatology and Rehabilitation

decisions about treatment and save costs – benefitting both the patient and the health system.

Fig. 1

Fig. 2

Therapeutic procedure Since an untreated Chlamydia infection can cause secondary damage to the urinary and genital organs, both the patient and his partner were treated with antibiotics in accordance with the applicable guidelines. Spondyloarthropathies are generally treated with regular physiotherapy, medication in the form of non-steroid antirheumatic drugs and, where appropriate, cortisone injections or the administration of immunosuppressive drugs (TNF inhibitors). Due to the gradual improvement he experienced over time, however, our patient did not want any therapy. Cortisone injections were not needed, since the swelling in the knee was subsiding. Treatment outcome and conclusion The MRI of the spine, which was repeated after about a year, revealed that the inflammation had almost completely disappeared. Clinically, the musculoskeletal system showed no further inflammatory symptoms either. This shows that the patient’s symptoms were attributable to reactive arthritis, which was triggered by the Chlamydia trachomatis bacterium, evidence of which was found in the patient’s urine. Thanks to new detection methods, the importance of this pathogen in relation to the onset of immunologically activated arthritis has been known for several years now. What is remarkable in this case is the fact that the patient showed no urogenital symptoms and that there was no evidence of the bacterium in the joint effusion. With the benefit of hindsight, it is clear that it was right to consider a relatively rare differential diagnosis, which could then be specifically treated with antibiotics, and to wait before proceeding with immunosuppressive treatment, which is both expensive and associated with possible side effects. Fig. 1 MRI of the sacrum: Left sacroiliac joint with bone marrow oedema (increased accumulation of fluid) as a sign of active inflammation (shown by circle)

Author: Dr. med. Anna Thoma, Senior Consultant, Rheumatology and Rehabilitation

Fig. 2 MRI of the sacrum after one year: Inflammation has largely subsided (shown by circle)

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Annual Report Manual Medicine Progress-oriented, diagnosis-based rehabilitation management The following case study demonstrates that acute rehabilitation based on an interdisciplinary approach paves

A 45-year-old female patient attends a consultation with us for further investigation following a fall from her mountain bike. She reports significant pain on the right-hand side of her lower back and in her right foot. The initial examination detects swelling in the right foot and pain on the right of the lower back and buttocks. The X-rays do not show any abnormalities. Due to the traumatic torsion of the upper ankle joint, the patient is provided with a MalleoLoc ® splint and forearm crutches. In accordance with the RICE rule (rest, ice, compression and elevation), only limited weight is put on the foot at first. In parallel with this, a plan is drawn up for conservative acute rehabilitation on an outpatient basis. After using osteopathic techniques for careful mobilisation and for treating the ligaments and muscles, the mobility of the tarsal bones gradually improves. The left leg is also treated during this process, paying particular attention to ensuring that the knee, hips and spine are functioning correctly. As the pain slowly subsides, more weight can be placed on the foot again. Since there is no improvement in the pain on the right-hand side of the sacral region after several days, a CT scan of the pelvis is required. The CT image reveals a hairline fracture in the sacrum without any displacement. Surgery is not necessary in this case – instead, pain therapy is extended until the fracture has healed. Meanwhile, positive progress is being made in dealing with the problem in the right foot, but it is not yet sufficiently stabilised because of the torn ligaments. Moreover, the patient is now noticing that her foot’s positional perception is restricted, which is having an adverse impact on her security when walking and her ability to keep her balance. In cooperation with the Department of Physiotherapy, the patient is therefore advised to carry out specific exercises at home using a balance board and on unstable surfaces.

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Manual Medicine

the way for a quick and sustainable healing process.

At the check-up a few weeks later, it is clear that the injury to the sacrum has healed well and is no longer causing any pain in this area. However, the pain has now shifted further outwards, particularly towards the buttocks.

Dr. med. G. Hämmerle Senior Consultant

At this point, clinical investigations reveal a blockage of the sacroiliac joint and significant tension in the gluteal muscles. Over the course of several manual therapy consultation sessions, the sacroiliac joint is mobilised, and the persistent muscle tension is relieved by means of dry needling with fine acupuncture needles. This resolves the patient’s remaining problems and the rehabilitation process is completed with a successful outcome.

Dr. med. E. Aschl Deputy Consultant

Side view of the sacrum

M. Forrer Osteopath D.O.

V. Seehusen Osteopath M.Sc.Ost.

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Annual Report Internal Medicine Top professional expertise in perioperative internal medical care Incorporating professional internal medical treatment into patient care enables even patients with complex underlying

The role of Internal Medicine Working in close cooperation with GPs, anaesthetists and orthopaedists, the task of the Department of Internal Medicine is to ensure the best possible progress of perioperative care and therefore guarantee an optimum post-operative outcome, particularly for patients with multiple concomitant internal diseases. This is achieved partly through an optimised pre-operative investigation process that is appropriate to the concomitant conditions concerned and partly through continuous internal medical care provided throughout the perioperative period if necessary. Only a highly capable team with broad, in-depth expertise can fulfil these requirements. The Internal Medicine team The expansion of Schulthess Clinic, creating 160 additional beds, has increased the clinic’s patient intake. To cope with the greater demands this brings, the structure of the Internal Medicine department also had to be adjusted. In February 2015, internal medicine specialist Dr. med. Margrith E. Knecht took over as departmental head. She succeeded Dr. med. Pieter Langloh, our long-serving Senior Consultant in Internal Medicine, who remains on hand to support the team as a senior consultant and expert in internal medicine and lung diseases. Internal medicine specialist Dr. med. Grozdana Bojanic was promoted to consultant as of 1 January 2016 and is now also the deputy departmental head. Since January 2016, Dr. med. Margrith E. Knecht and Dr. med. Grozdana Bojanic have been supported by three internal medicine specialists from our partner hospital in Zollikerberg: Dr. med. Maria Goridis, Dr. med. univ. Susanne Greber and Dr. med. Kathrin Mosimann will assist the department as deputy consultants and full members of the team on a four-monthly rotational basis. To cover the broad spectrum of concomitant internal diseases, we are currently in the process of appointing another experienced internal medicine specialist. For help with background and consultation services and special diagnostics and therapy, the Internal Medicine team relies on support either from external specialists with their own practices and or from staff from the Department of Internal Medicine at Spital Zollikerberg, led by Departmental Head Prof. Dr. med. Ludwig Th. Heuss. This gives the team a vast pool of specialist knowledge to draw on in a range of different fields and enables them to provide the best possible diagnostic and therapeutic services – 365 days a year. The new observation ward November 2014 saw the opening of an observation ward with four beds for monitoring, with medical support provided by the Department of Internal Medicine. If necessary, patients can be brought here after spending time in the Recovery or Intermediate Care units for continued close monitoring of their general state and respiratory, heart and cardiovascular functions until their condition is completely stabilised. This allows any possible complications to be prevented or detected at an early stage and treated accordingly, particularly in the case of patients who are at a higher risk during the perioperative period due to multiple internal diseases.

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Internal Medicine Medico-Legal Affairs

conditions to undergo orthopaedic surgery to improve their mobility and thus enhance their quality of life.

Annual Report Medico-Legal Affairs Pooling expertise for complex medico-legal affairs At the end of 2015, the “Pain Management and Medico-Legal Affairs” department was turned into the Department for Medico-Legal Affairs, which deals exclusively with assigning, processing and overseeing expert reports, quality control and internal consulting on issues relating to medical insurance.

Dr. med. M. Knecht Senior Consultant Internal Medicine

Dr. med. G. Bojanic Consultant Internal Medicine

Team Since May 2014, the department has been led by Consultant Dr. med. Georg Egli, a neurologist certified by the Swiss Medical Association (FMH). The founder of the department, Prof. Dr. med. Bogdan Radanov, has since remained on hand as a senior consultant to provide expert opinions on psychiatric matters. Although we are affiliated with the Department of Neurology, we operate independently. This makes us both the smallest department at Schulthess Clinic and yet also the largest, as we are able to draw on a vast pool of proven specialists from across the entire clinic, spanning the fields of orthopaedics, neurosurgery, rheumatology and neurology. The combined expertise of a specialist clinic that covers all essential areas of orthopaedic medicine provides the basis for a uniquely differentiated assessment of contentious health risks, which is particularly useful when it comes to preparing complex expert reports (reports for courts, decisive expert opinions). Scope of activities Our clients are insurance companies and courts. The range of issues we deal with covers all medical disciplines, although they mostly relate to neurology (including neuropsychology, e. g. in the case of brain injuries), orthopaedics and rheumatology, sometimes involving psychiatry as well. External specialists are brought in to help with more unusual matters. The partial reports provided by these proven experts from various disciplines are discussed collectively to reach a consensus and then incorporated into the overall medical assessment in each case.

Dr. med. G. Egli Head of Medico-Legal Affairs

Prof. Dr. med. B. Radanov Senior Consultant

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Sports Medicine

Annual Report Sports Medicine At the head of the game “Success begins in the mind” – a truism that comes up time and again in life, and not just for athletes.

Dr. med. G. Büsser Departmental Head

Dr. med. S. Sannwald Senior Consultant

As the central control mechanism for our bodily functions, the brain is limitless – and not just as a topic of scientific discussion. It also gives every one of us the potential to push beyond apparently fixed physiological limits and achieve “the impossible”. The heart is known to have a defined stroke volume and a maximum heart rate, the lungs have a reproducible respiratory capacity, and the working muscles build up strength in a measurable way. Yet there are many systems that can sometimes have a significant influence on the performance we can actually achieve. You could call these faculties something like character, willpower or a winning mentality. The important thing for athletes to realise is that a body that functions perfectly from an objective perspective also needs this passion to make it truly powerful. At our clinic – with all the highly specialised, primarily orthopaedics-oriented areas it covers – the discipline of sports medicine often plays a supplementary, interdisciplinary role in getting reconstructed joints moving again and, if need be, making them fit to produce top sporting performances. Various conservative treatment methods are brought into play, often in cooperation with other disciplines and physiotherapy or occupational therapy. Based on our instinctive understanding of athletes and the experience built up over many years on the front line of competitive sport, our aim is to enable athletes to work on their injuries under appropriate guidance and with undiminished confidence and motivation. With Dr. med. Gery Büsser, Dr. med. Stefan Sannwald and Dr. med. Philipp Sacherer, our clinic boasts an experienced team of medical experts from professional clubs and sports associations. Since the summer of 2015, it has been strengthened further by the addition of generalist Dr. med. Carsten Friederich. He has spent several years working in neural therapy, which involves influencing regulatory processes and often helps to achieve unexpected therapeutic success. This area of activity at the interface between medicine, sport and science provides the basis for applied sports medicine, which has been strongly advocated by top sports clubs and members of the Swiss Olympic association for years. As Schulthess Clinic’s Sports Medicine team, we are proud to be able to put our knowledge and expertise into practice in professional and amateur sport.

Dr. med. C. Friederich Deputy Consultant

Dr. med. P. Sacherer Deputy Consultant

The ZSC Lions sports ambulance – with Dr. med. Gery Büsser at the wheel to provide assistance

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External sports care Our athletes on the way to the Olympic Games in Rio

In the final year before the 2016 Olympic Games in Rio, the sports care activities at Schulthess Clinic were also devoted to this upcoming major event. In some sports the focus was already on gaining vital qualifying points, while

Our sports physiotherapists spent a record number of days on the road with athletes from our partner associations, attending training camps and tournaments all over the world. In the year under review, they clocked up a total of 425 days providing external sports care: 140 days for the Swiss Volley beach volleyball teams 160 days for the Swiss Volley indoor national squad 8 days for the Volleyball Talent School 75 days for the national rowing team 22 days for Swiss Fencing 16 days for the Fed Cup team 4 days for the Swiss Sailing team Beach volleyball It is now almost a tradition for Swiss Volley’s national squads to begin their pre-season preparations in Tenerife. Sports physiotherapists from Schulthess Clinic (Stefan Schönenberg, Estelle Hofstetter, Stefan Zingg and Cornelia Anderes) accompany the teams to the training camps and provide support there, as well as travelling with them to tournaments across the globe as members of staff. Following an injury-plagued start to the season and the Beach Volleyball World Championships in the Netherlands, the second half of the season proved very successful. The women even managed to claim a tournament victory and a number of other podium places in Sochi and Xiamen. By the end of 2015, two women’s national teams were in line for a starting spot at the Olympics. Their task in early 2016 is to defend these positions in order to turn their Olympic dream into reality. Our expertise in sports medicine is also in high demand at Switzerland’s two biggest beach volleyball tournaments, the prestigious Grand Slam in Gstaad and Beachmania in Biel, which will double up as the European Championships in 2016. At both these events, Schulthess Clinic provides a passionate and enthusiastic medical team that is always on hand to offer medical care for athletes from all over the world. Indoor volleyball From 3 to 14 July 2015, the Swiss Volleyball Federation took part in the biennial World Student Games (Universiade), which is open exclusively to students under the age of 28. The event was hosted by the South Korean city of Gwangju and involved 12 885 athletes from 143 countries – the first time it had ever exceeded the number of participants at a Summer Olympics. The Games also saw two Swiss teams competing for the first time. Even in the preliminary rounds, the teams faced some relatively tough opponents, with the women up against Ukraine, Chinese Taipei and Russia, and the men doing battle with Thailand, Russia and Canada. Nevertheless, after some initial difficulties they both achieved a satisfactory result, with the women finishing in 11th place and the men 10th.

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Sports Medicine

in others it was all about getting targeted physical preparations under way.

Fig. 1

Sports physiotherapists Patrizia Zanetti and Anita Zwahlen shared their treatment rooms in the athletes’ accommodation area with colleagues from other fields (handball, basketball and five therapists working with individual athletes). Fortunately, there were no acute injuries in the elite women’s team, although the players often complained of injuries due to overuse, which had been bothering them ever since the winter season. As for the men, one outside hitter suffered a supination trauma and had to be provided with physiotherapy first aid on site. Swiss Rowing Association Switzerland’s elite rowers enjoyed one of their most successful years in a long time in 2015. They managed to secure four quota places for the 2016 Olympic Games in Rio at the World Rowing Championships in Aiguebelette – with Jeannine Gmelin in the Women’s Single Sculls, Barnabé Delarze, Roman Röösli, Augustin Maillefer and Nico Stahlberg in the Men’s Quadruple Sculls, Daniel Wiederkehr and Michael Schmid in the Lightweight Men’s Double Sculls, and Mario Gyr, Simon Niepmann, Simon Schürch and Lucas Tramèr in the Lightweight Men’s Fours. The lightweight fours also won the World Championship title – the first for Switzerland for 20 years ! These excellent performances are the result of the impeccable teamwork of all those involved: the rowers, trainers, clubs and medical team all pulled together to propel the boats to a successful finish (Fig. 1) !

Fig. 1 Lucas Tramèr, Simon Schürch, Simon Niepmann and Mario Gyr celebrate their World Championship medal and Olympic qualification. (Photo: Detlev Seby, Swiss Rowing Association)

Swiss Fencing Some members of Switzerland’s national fencing squad have already been attending twiceweekly athletics training sessions at Schulthess Clinic with Markus Dohm-Acker and Katrin Moser since 2012. With the 2016 Olympics in mind, this collaboration was stepped up further, with a sports physio team comprising Thomas Rosenheck, Patrizia Zanetti and Anita Zwahlen accompanying the fencers to World Cup and Grand Prix events in 2015 and supporting them on their “road to Rio”. The first action took place in Paris. Despite their formidable reputation, Swiss fencers Max Heinzer, Fabian Kauter, Benjamin Steffen and Peer Borsky produced a disappointing performance in the team competition and even dropped out of the running with the worst result. The Swiss fencing team’s aim is to break into the top five in the world by the end of the Olympic qualification tournament in Vancouver in mid-February 2016. This will ensure that three of the four team members also qualify for the individual competition at the Olympic Games. Next on the agenda were a training camp in Tenero, the European Championships in Montreux – with excellent results (third place for Max Heinzer in the individual competition and for the Swiss team) – and finally the World Championships in Moscow (another third-place finish for the Swiss team). After a well-deserved break, the season kicked off on home territory in Bern. Unfortunately, the team once again had to settle for tenth place, as they did in Paris. The next stop was the Estonian capital Tallinn, where the Swiss team came a very respectable third in spite of a medical timeout in the individual competition when young and coming-up fencer Michele Niggeler suffered a supination trauma. Despite being in severe pain, he did not want to abandon the fight and –

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Fig. 3

thanks to the tape applied to his foot by sports physiotherapist Anita Zwahlen – he went on to win not only this contest but also another one on the same day, only admitting defeat to a clearly superior opponent in his third encounter. The season ended in Doha with the last Grand Prix of the year, with 18 athletes from Swiss Fencing taking part. The sports physiotherapy team therefore had plenty of work to do. Fabian Kauter secured an impressive second place to finish this tournament on the podium. Swiss Sailing In October, windsurfer Mateo Sanz Lanz claimed the first Olympic qualifying spot for the Swiss national sailing team with his sixth-place finish at the World Championships in Oman. We have particularly close links with Switzerland’s elite and junior sailors, as National Physic Coach Fabian Neunstöcklin is responsible for coordinating their performance diagnostics and individually adapting their training plans to their performance level and boat class (Fig. 2). Performance diagnostics for individual athletes too For several years now, Schulthess Clinic has also been providing performance diagnostics services for some individual athletes. Based on a performance test, the sports scientists come up with tailored training plans and recommendations. Marathon runner Christian Kreienbühl is one of the athletes to have undergone performance testing at Schulthess Clinic. Following the 2014 European Athletics Championships on home turf in Zurich (team bronze medal with Viktor Röthlin and Tadesse Abraham), Kreienbühl just about managed to successfully qualify for the Olympic Games in Rio in September, finishing the Berlin marathon just three seconds under the qualification limit. His time of 2 :13: 57 ranked him eighth amongst the European runners in Berlin (Fig. 3).

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Fig. 2

Golf Medical Center Pioneering medical care and training support for golf

2015 saw continued interest amongst golfing circles in the activities of the GMC and the Albatros Golf Fitness training. A core customer base has been established both at Schulthess Clinic and in Kloten, making regular use of the services offered by the GMC.

The number of patients referred to the specialists at Schulthess Clinic for further treatment via the GMC fell slightly compared to the two previous years. One possible reason for this is that, due to absences, no consultations for golfers were run between August and the end of October 2015. Some golfers are also already registering directly with Schulthess Clinic for treatment, which suggests that the clinic is increasingly being seen as a centre of excellence for golf and the Golf Medical Center is becoming more established as an institution for new referrals. On average, the GMC’s medical services are currently used by around 110 to 150 people a year. The problems dealt with by the GMC in figures Since we started recording statistics in 2013, we have built up the following picture of our activities: 2013

2014

2015

Knee problems

43

47

41

Shoulder problems

20

18

19

Back problems

21

36

28

Hand and wrist problems

4

4

4

Elbow problems

4

13

3

Foot problems

14

16

8

Hip problems

6

10

6

7

4

17

5

4

131

148

117

Physiotherapy and Albatros referrals Other problems Total

These statistics are intended to provide a long-term indication of which problems prompt golfers to seek medical advice and how they are distributed around different parts of the body. Over time, this will also reveal the range of conservative and surgical measures taken to deal with these problems. Fig. 2 Windsurfer Mateo Sanz Lanz qualifies for the 2016 Olympics. Fig. 3 Christian Kreienbühl undergoes a lactate test as part of his performance diagnostics

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Since autumn 2015, Dascha Drobny has been writing regular contributions on Golf Fitness on behalf of the GMC for Swiss Golf Traveller, an online platform run by the airline SWISS. These are scheduled to be published three times a year. Now styled the “Albatros Golf Trophy”, our traditional Schulthess Clinic golf tournament was held for the third time at the Unterengstringen Golf Club in collaboration with André Bossert. Loyal Albatros training customers and doctors from Schulthess Clinic were invited to join in the occasion. In terms of gross score, Dr. med. Nils Horn won the men’s tournament while Birgit Metzler emerged victorious amongst the women. All in all it was a thoroughly enjoyable event, including the fringe programme and subsequent cocktail buffet, with Jackie Dangel, Alessia Birolini and Dascha Drobny playing an instrumental role in ensuring its success, as they do every year. The information evening on 30 October 2015 was all about “Golf and the shoulder”. Once again, the event proved more popular than the capacity of our lecture hall, which can only seat 140 people, could accommodate. The 60 people who unfortunately had to be told that there was no more space available have been informed that next year’s event will be taking place in our new lecture hall, which has room for 400 people, so it is unlikely that anyone will have to miss out in future. The highlight of the evening was undoubtedly the lecture given by Dr. med. Hans-Kasper Schwyzer, which featured some interesting cases involving golfers, who also reported on their own experiences before and after shoulder surgery. Dani Nieth added to the great atmosphere at the event with his entertaining talk on communication on the golf course, while Gabi Tobler and Beat Grossmann stirred up the audience with their shoulder-specific Golf Fitness presentation.

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From practice, for practice In 2015, we once again had two articles published in the health column of the GOLFSUISSE magazine. The article “So schmerzt die Schulter nicht” (“Avoiding shoulder pain”) co-authored by Dr. med. Hans-Kaspar Schwyzer, Head of the Shoulder Surgery department, was featured in March, while a piece entitled “Die fünf Golfer” (“The five golfers”) on the topic of golf amongst the elderly and involving former Head of Internal Medicine Dr. med. Pieter Langloh appeared in November 2015.

Fig. 5

Fig. 6

The training courses for Golf Fitness trainers proved very popular, just as they have in previous years. What is required in golf in terms of physiotherapy, sports medicine and orthopaedics is now common knowledge. With the GMC, Schulthess Clinic has once again succeeded in playing a pioneering role in what was previously uncharted territory. Pictured in Fig. 5 is the triumphant winner Dr. med. Nils Horn, with Dascha Drobny, co-founder of the Albatros Golf Fitness training scheme, to his left and Gabriella Baumann-von Arx, publisher of the best-selling golf books “Partherapie” (“Par therapy”) and “Single in 365 Tagen” (“Single in 365 days”), to his right. The aforementioned books were presented as prizes. Fig. 6 shows André Bossert, Switzerland’s most successful golfer of all time, along with Frank Baumann, the only current golf entertainment pro, Gioia Carpinelli, a member of the Swiss national squad, and Dr. med. Tomas Drobny, Head of the Golf Medical Center, shortly before the start of the tournament.

Fig. 5 (From left) Dascha Drobny, Dr. med. Nils Horn, Gabriella Baumann-von Arx Fig. 6 (From left) André Bossert, Frank Baumann, Gioia Carpinelli, Dr. med. Tomas Drobny

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Therapy and Training

Annual Report Therapy and Training Applying and acquiring knowledge Schulthess Clinic’s therapeutic departments boast an excellent reputation beyond the clinic itself. Our therapists are in high demand as speakers at national and international congresses and do their bit to pass on knowledge and expertise both internally and to the outside world and preserve it for the long term.

Physiotherapy report The annual International Cartilage Congress took place in Freiburg im Breisgau from 23 to 24 January 2015. The pleasant and relaxed atmosphere set against a picturesque backdrop provided the perfect platform for interdisciplinary exchange. The programme featured a variety of interesting and inspiring short presentations on diverse surgical techniques. A satellite symposium for physiotherapists was also held, for the first time in this format, offering an equally varied mix of fascinating contributions. S. Rüdisühli Head of Therapy and Training

R. Denzler TL for Spinal Physiotherapy

On the second day of the congress, Uli Maroska gave a lecture on arthrofibrosis, a topic that is still largely unexplored, attracting a great deal of interest from the audience. The satellite symposium was rounded off with a talk by Anja Kobelt on “Electrical stimulation to support muscle function”: according to the latest findings, better results are achieved using what are known as multi-path systems, which provide deeper and longer-lasting stimulation through alternating impulse circuits, than with the single-path systems primarily used to date. The physiotherapy satellite symposium was attended by an attentive and interested audience, who contributed to the exciting and stimulating discussions and lively exchanges after the talks. BBS Congress in Bern in 2015 The 7th Shoulder Meeting, which took place at Bern’s Zentrum Paul Klee on 2 and 3 July, offered doctors and physiotherapists a unique opportunity to share professional expertise. Seraina Schmid-Vital gave her presentation on “Rehabilitation after microfracturing of the glenohumeral joint” to a large audience. Schulthess Clinic has already been performing the operation for microfracturing on the lower extremities and the shoulders for several years now. The next day, Seraina Schmid-Vital teamed up with Merel Sonderegger to run an entertaining and varied workshop for physiotherapists on the same topic, which included comparing the rehabilitation of upper and lower extremities.

M. Dohm-Acker TL for MTT and Training

U. Maroska TL for Lower Extremity Physiotherapy

To be continued ...

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Occupational Therapy report When Katrin Hartmann went on maternity leave at the start of 2015, Charles Mayor was brought on board as a highly capable successor to the post of Team Leader. He already had previous experience of working in occupational therapy at Schulthess Clinic and integrated quickly to ensure a virtually seamless transition. Isoforce splint workshop The areas of research and knowledge transfer were also a hive of activity last year. Following on from the first Isoforce splint workshop at the Swiss Society for Hand Rehabilitation (SGHR) congress in Biel in 2012, the first advertised course on this topic took place at Schulthess Clinic in 2015. Moreover, two of our colleagues went beyond Swiss borders in March to publicise the Isoforce splints developed at Schulthess Clinic at a workshop in Berlin. This event also provided an opportunity to present our carpometacarpal osteoarthritis exercise programme based on scientific studies. German Hand Congress At the German Hand Congress in September 2015, Ellen Dietrich presented her pilot study comparing the use of firm and soft positioning splints after trapeziectomy surgery and our three newly developed follow-up treatment schemes for this operation. The choice of which scheme to use in each case is based on an intraoperative assessment of the stability of the thumb. This presentation met with keen interest, with a particularly positive response from some doctors to the short-term immobilisation included in one of the schemes. A workshop on Isoforce splints was also offered at this congress. SGH / SGHR Annual Congress Ellen Dietrich spoke in depth about her study at the joint Annual Congress of the Swiss Society for Hand Surgery (SGH) and the Swiss Society for Hand Rehabilitation (SGHR) in Fribourg in November. Once again, her talk was well-received and it even earned her the SGHR Award for the best contribution – a great success !

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MAS completed Seraina Schmid-Vital successfully completed her MAS degree in Managed Health Care in February 2015. In her Master’s thesis entitled “Unternehmen im Wandel – Wissen erhalten” (“Changes in business – preserving knowledge”), she explored the topic of knowledge management and its implementation within a corporate framework. Her thesis demonstrates that well-organised knowledge integration is essential for ensuring long-term success and can boost a company’s reputation. To maintain high quality standards on a long-term basis, knowledge – especially the practical knowledge acquired over the years and passed on from person to person – should be systematically incorporated into day-to-day physiotherapy operations. The Department of Physiotherapy at Schulthess Clinic is currently working with the Kloten Satellite Clinic to develop specific measures for implementing a structured knowledge management system.

Performance Diagnostics The Performance Diagnostics team offers health checks and training advice to anyone who needs them. Sporting beginners and recreational athletes can benefit from the same infrastructure, testing procedures and expertise from the team of sports scientists that are used to help top athletes. These include an analysis of training habits and a detailed evaluation discussion based on test results. More patients also took up the offer of tailored training plans in 2015. C. Mayor TL for Occupational Therapy

T. Rosenheck TL for Sports Physiotherapy

Our health checks are designed to benefit anyone who wants to strengthen their cardiovascular and musculoskeletal system through regular physical training. Patients gain a detailed insight into their state of health from both a medical and a sports science perspective and receive advice on ideal ways to look after their health with regard to everyday activities and physical exercise. Switch to new therapy planning software The new therapy planning software went live in August 2015, on schedule and without any major problems. With the analysis of the existing planning processes having been completed back in late 2014, the focus in spring 2015 was on implementing and parameterising the new system. At the same time, a detailed manual was drawn up, which proved very helpful in the training sessions carried out later on during the summer. Nevertheless, the switchover involved a great deal of administrative work for the Therapy department, as several thousand appointments had to be transferred onto the new system. Schulthess Training report Although there is now much more space available in the training room thanks to the clinic’s building extension, Schulthess Training is still very busy at certain peak times. The steady rise in demand is also reflected in our statistics: the number of customers was up more than ten percent on the previous year, increasing to 598. These encouraging figures show that our customers very much appreciate the care and support we provide and all our efforts are paying off.

S. Schmid-Vital TL for Upper Extremity Physiotherapy

A pilot project was launched at the end of 2015 to facilitate a smoother transition from physiotherapy to medical training therapy, the aim being to optimise patient care in medical training therapy. The objective here is to ensure that patients benefit as far as possible from the expertise on offer in both areas – physiotherapy and sports therapy.

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Teaching, Research and Development

Annual Report Teaching, Research and Development Research aimed at optimising patient treatment Close cooperation between researchers and medical staff provides the basis for internationally acclaimed scientific projects with findings that help to improve the future of patient treatment.

In the year under review, the Teaching, Research and Development (TR & D) department once again saw the successful completion, presentation and publication of numerous research projects, as shown by the list of publications included in this Annual Report. Many of these works, which included outcome research, clinical studies, validation studies and basic research, etc., involved researchers from Switzerland and abroad. In addition, our interdisciplinary activities focused particularly on the areas outlined below. PD Dr. phil. L. Audigé Research Group Leader Upper Extremities and Hand Surgery

Quality management system for clinical research In light of the new Human Research Act, we have developed and implemented a quality management system (QMS) for clinical research. This enables us to continue guaranteeing maximum protection for Schulthess Clinic patients taking part in studies for research purposes. The QMS applies to all research projects that require authorisation from the Cantonal Ethics Committee by law. It forms an integral part of the Schulthess Clinic QMS and is structured on the basis of the various phases of a research project. In a further effort to improve patient protection, we have also worked with the Cantonal Ethics Commission to produce a new consent form regarding the use of health-related data for research purposes and introduced it across the clinic.

Lic. phil. M. Hersperger Group Leader, Research Management

Electronic data collection The registry project supported by the Mäxi Foundation entered the pilot phase last year. For the first time, the Department of Lower Extremity Orthopaedics carried out its patient surveys using electronic forms on iPads. The Hygiene department also switched from using paper forms to entering data directly in the electronic registry database for documenting cases of infection. The foundations have therefore been laid for a clinic-wide, standardised data collection system. If the pilot phase proves successful, this electronic data collection system may subsequently be extended to other departments where data is needed for research or for routine clinical practice.

Dr. phil. F. Impellizzeri Research Group Leader Lower Extremities

Partnership with ETH We have further expanded our cooperation with ETH Zurich. As well as conducting joint research projects and supervising Master’s theses, Schulthess Clinic and ETH Zurich also offered their first joint course for students on the “Health Sciences and Technology” (HEST) Master’s degree programme in the year under review, which took place at Schulthess Clinic. The lectures on “Clinical Challenges in Musculoskeletal Disorders” received extremely positive feedback from the students. They highlighted some particular plus points, such as the way that the course directly linked theoretical knowledge with the challenges of everyday clinic practice and the opportunity it provided for direct contact with the experts at Schulthess Clinic.

Prof. Dr. phil. A. Junge Research Group Leader, F-MARC

To be continued ...

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News from the Human Performance Lab (HPL) One of the most important changes to take place in 2015 was the move into our new laboratory facilities at the end of March. The HPL now has more than twice as much space available as before. In addition, workspaces were created in an adjacent room, particularly to accommodate for our Master’s and doctoral students. Thanks to financial support from the Mäxi and Baugarten Foundations, we were also able to expand our range of laboratory equipment. For instance, we now have a permanently installed Vicon system (ten cameras for 3D motion analyses), three Kistler force plates and an emed ® platform from Novel (for measuring foot pressure), which has been built directly into the floor. All systems were installed at the end of the year and the HPL team will now familiarise themselves with them so that they can get started on their first studies soon. Dr. phil. Nicola Maffiuletti and Dr. phil. Bernd Friesenbichler continued their active involvement in two major European projects, “Life Long Joints” and “Ambient Assisted Living”, in 2015. The collaboration between ETH Zurich and the HPL in connection with the “Health Sciences and Technology” Master’s degree programme was further expanded last year. For example, the sports physiology practical course on surface electromyography (EMG) was run once again under the guidance of the HPL team. Dr. phil. Nicola Maffiuletti also gave a lecture on the topic of “Evaluation and Treatment of Muscle Weakness in Orthopaedics”. The HPL team also underwent some personnel changes. Karin Mani filled in for Julia Item during her maternity leave from the beginning of July to the end of the year. At the start of August, Romana Brunner began her doctoral (PhD) project at the University of Lucerne under the supervision of Dr. phil. Nicola Maffiuletti and Prof. Dr. Karin Niedermann (ZHAW), with the working title “Injury prevention in ice hockey”. Meanwhile, congratulations are due to Vanessa Wellauer on her promotion to Senior Research Assistant. Raphael Huber and Melanie Rieser (both from ETH) successfully finished their Master’s theses under the supervision of Dr. phil. Nicola Maffiuletti and Dr. phil. Nicola Casartelli, respectively. Rosa Visscher from the University of Groningen (Netherlands) completed her practical training in the Human Performance Lab, writing her Bachelor’s thesis while she was there. The HPL team also supervised the following Master’s students: Benedikt Mündle (ETH), Daniela Pacifico (ZHAW), Patrick Sumi (ETH) and Alessandra Ventura (ETH). News from Lower Extremity Orthopaedics 2015 was the second year of activity since the conception of the Lower Extremity Research Group that has been created to support and coordinate the clinical research studies of the Lower Extremity department, in particular those studies using clinical measures and subjective assessments such as patient-orientated measures (e. g. questionnaires). In 2015 we have consolidated the research activity in our priority area (clinical outcome studie), publishing articles examining the validity of questionnaires developed for measuring pain and function in patients undergoing surgical treatments for hip disorders. However, an important evolution of the Lower Extremity group activity has been the development and planning of new projects focusing on surgical treatments for foot and knee orthopedic problems. Patient-related measures are now systematically collected at specific time points (before and after surgery) on selected patients operated by the Foot and Ankle Surgery department (e. g. plantar plate and

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In the following, the individual research groups report on their activities in 2015:

Kelly-Keck), and on all the patients operated for ACL rupture, cartilage and knee prosthesis. The Foot and Ankle surgery department is also testing a pre-final version of a software for collecting data from the patients using a web-based interface running on tablets and iPads. In order to handle the increased amount of data collection increased amount of data collected and their analysis, new research (Danica Mauz) and study (Myrta Villoz) assistants joined our team. In addition, Vanessa Wellauer has been promoted to Senior Research Assistant and Selina Nauer is now in charge of the UE registry system. At the beginning of 2015, the head of the research group, Dr. phil. Franco Impellizzeri, was invited to lecture in Salt Lake City for the AO Trauma North America Course on Surgical Preservation of the Hip on the optimal use of instruments for lessons about the optimal use of instruments for examining the outcome of treatments from patient-perspective, confirming the international recognition of the research activity of the Lower Extremity group in the field of clinimetrics (clinical measures). Dr. phil. N. Maffiuletti Research Group Leader, Human Performance Lab (HPL)

PD Dr. phil. A. Mannion Scientific Advisor Spine Surgery and Neurosurgery

D. O’Riordan BSc Administrative Research Group Leader, Spine Surgery and Neurosurgery

News from Upper Extremity Orthopaedics and Hand Surgery For years, one of the key areas of activity in the Upper Extremity and Hand Surgery department has been maintaining and developing specific clinical registries for quality improvement. The shoulder prosthesis registry now comprises more than 2000 interventions, for which the first tenyear follow-up checks are due to be carried out in 2016. Details regarding the state of health, type of treatment and therapeutic outcome for all patients undergoing arthroscopic rotator cuff repairs, treatment for Dupuytren’s contracture or proximal interphalangeal joint implants have been documented for some time now. Recently, we have also started recording all patients receiving treatment in our department for a fracture, infection or bone healing problem in our trauma registry. To continuously optimise and supplement our workflows and documentation, we are developing electronic data collection processes. These will enable patients to complete questionnaires at home on a PC or tablet computer, for example. Paper questionnaires will naturally still be provided for patients who prefer this option. In terms of research, our main focus is still on conducting a cost-benefit analysis of orthopaedic interventions and standardising the process of recording surgical complications. We have managed to obtain support from Suva, as well as nine major health insurance providers, for the collection of health-related cost data as part of an ongoing study. Together with an international group of experts, we have drawn up a consensus list of complications (“core event set”) following arthroscopic rotator cuff reconstructions and incorporated it into the corresponding registries for further evaluation. In similar projects, we have also looked at complications after shoulder joint or prosthetic proximal interphalangeal joint implants. For the first time, we are also providing support for scientific projects run by the Department of Anaesthesiology. Two randomised clinical studies have been initiated so far, investigating the practicality of new laryngeal masks and their influence on patients.

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In addition to our long-standing partnership with the Center of Experimental Rheumatology at University Hospital Zurich, we also expanded our collaboration with ETH Zurich: in the field of hand surgery, we continued with the development of a camera system for investigating the biomechanics of the proximal interphalangeal joint, while in relation to shoulder prosthetics we used a computer simulation (known as a finite element analysis) to examine the impact of implant components on the glenoid cavity (e. g. type and position of the fixation screws). News from the Spine Center In 2015, members of the Spine Center published 24 peer-reviewed journal articles and presented 23 peer-reviewed conference abstracts. We enjoyed two “Scientific Writing Weekends” in 2015, which allowed the clinical and research staff to come together, away from the distractions of the clinic, to write-up their research papers and plan new projects. Prizes and Awards In Sept 2015, Anne Mannion and a group of international colleagues were awarded the prestigious EUR 10 000 Full Paper Award from EUROSPINE for their paper “Age and pro-inflammatory gene polymorphisms influence adjacent segment disc degeneration more than fusion does in patients treated for chronic low back pain” (Omair A, Mannion AF, Holden M, Leivseth G, Fairbank JC, Hagg O, Fritzell P, Brox JI). In Nov 2015, her work with another international research group was awarded the North American Spine Society and The Spine Journal 2015 Outstanding Paper Award for Surgical Science: “Total disc arthroplasty versus anterior cervical interbody fusion: use of the Spine Tango registry to supplement the evidence from RCTs” (Staub LP, Ryser C, Röder C, Mannion AF, Jarvik JG, Aebi M, Aghayev E). In Nov 2015, Laura Pochon was awarded a Spring Term Semester Prize by the Medical Faculty of the University of Zürich for the high quality of her Master’s thesis supervised by Anne Mannion. We are very proud of Laura’s achievement and congratulate her on winning the prize. In Dec 2015, funding was awarded for another three years to the multicentre “European Spine Study Group” project, in which the Schulthess Spine team (led by Frank Kleinstück) and 5 other international spine centres are investigating clinical outcomes following conservative and surgical treatment of adult spinal deformity.

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Several clinical studies and scientific projects were successfully completed, presented at congresses and published in international journals during the year under review. These included, for example, an analysis of the clinical outcomes for patients with bilateral inverse shoulder prostheses. We also presented the evaluation of a special survey of hand patients at an international level. As part of work being carried out on medical theses at the Universities of Basel and Zurich, research was conducted into topics such as returning to sport after shoulder replacements, indications and outcomes for shoulder prostheses following proximal humerus fractures, and treatment options for patients with Dupuytren’s contracture. A Master’s thesis at ZHAW on evaluating the quality criteria of the EuroQoL EQ-5D-5L quality of life questionnaire for patients with carpal tunnel syndrome was successfully defended.

Personnel In Aug 2015, we welcomed to the team Manuela Kobelt MSc to take over the running of the “Appropriate Use of Surgery” project (maternity cover for Francine Mariaux) and Stephanie Dosch MSc to manage the Spine Tango surgical form documentation (maternity cover for Kirsten Clift). We were sorry to have to say goodbye to Kirsten in December. We thank her for her excellent work in the last 7 years and wish her well for her future in UK. Invited lectures In Nov 2015, Anne Mannion was invited to give 3 lectures at the International Spine Tango Users Meeting in Bern. The Schulthess Spine Center co-pioneered EUROSPINE’S Spine Tango registry and currently contributes over 1000 spine surgical cases / year, along with patient outcome data before surgery and up to 5 years’ after. We were proud to be able to share our vast experience with others. Education Under the supervision of Anne Mannion, Pascal Zehnder completed his Masters project in the Faculty of Human Medicine and Dentistry, University of Zürich: “Influence of previous surgery on patient-rated outcomes after spine surgery”. The paper was accepted for publication in the European Spine Journal. We congratulate Pascal on his success. News from the FIFA Medical Assessment and Research Centre (F-MARC) At the 3rd FIFA Medical Conference medical representatives and leaders of FIFA’s 209 member associations gathered on 27 and 28 May 2015 in Zurich for discussion on the latest scientific advances related to football and health. Reflecting the work of FIFA Medical Assessment and Research Centre (F-MARC) the watchword was “Prevention“: Prevention of injuries, prevention of sudden cardiac arrests, prevention of doping to name just a few. Going a step further, participants also discussed the unique potential of football as a tool for the improvement of public health. Since its establishment in 1994, F-MARC has conducted a number of scientific studies and developed innovative programmes to tackle health issues. The regular practice of the complete warmup programme “FIFA 11+“ can reduce injuries by up to 50 %. The scheme has been successfully implemented in a number of member associations, including FIFA World Cup™ champions Germany, and will be further extended.

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Moreover, seeing that football itself can be a fantastic tool for improving general health, F-MARC progressively moved from a concept of “Medicine for Football“ to “Football for Health“. Launched as part of FIFA’s medical legacy to Africa on the occasion of the 2010 FIFA World Cup™, “FIFA 11 for Health“ was then extended to Latin America, Oceania and Asia, and is now being introduced in the Caribbean and Europe. Five years after its launch, more than 200 000 children in 20 countries have benefited from the programme. Studies published in well-respected scientific journals have proven that it has achieved a significant increase in children’s health knowledge. In 2015 a modified version of “FIFA 11 for Health“ was also used to tackle the epidemic of Ebola in the three most affected countries (Figure on page 93, top left). Concurrent with the FIFA Medical Conference, the renowned British Journal of Sports Medicine published a supplement on: Twenty years of the FIFA Medical Assessment and Research Centre: from “Medicine for Football“ to “Football for Health“ (see below) (Figure on page 93, top right).

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In recent years, FIFA has taken a number of measures to tackle sudden cardiac arrest. Medical examinations are conducted prior to all FIFA competitions to identify those who are predisposed towards cardiac issues. In addition, F-MARC has developed a FIFA Emergency Medical Bag, including an automated external defibrillator (AED), which can become a life-saving device in case of incident on the pitch. All FIFA member associations were provided with an emergency bag, and the conference in Zurich was the occasion to stress the urgent necessity for such equipment to become standard at all football matches.

Poster for FIFA’s “11 against Ebola” campaign

Cover of the British Journal of Sports Medicine

Important publications (selection) Audigé L, Blum R, Muller AM, Flury M and Durchholz H. Complications following arthroscopic rotator cuff tear repair: a systematic review of terms and definitions with focus on shoulder stiffness. Orthop J Sports Med 3: 2325967115587861, 2015. (Impact factor: not yet evaluated) Brunner R, Maffiuletti NA, Casartelli NC, Bizzini M, Sutter R, Pfirrmann CW and Leunig M. Prevalence and functional consequences of femoroacetabular impingement in young male ice hockey players. Am J Sports Med (Epub ahead of print) DOI : 10.1177/ 0363546515607000, 2015. (Impact factor: 4.362) Casartelli NC, Leunig M, Maffiuletti NA and Bizzini M. Return to sport after hip surgery for femoroacetabular impingement: a systematic review. Br J Sports Med 49 : 819 – 824, 2015. (Impact factor: 5.025) Dvořák J and Junge A. Twenty years of the FIFA Medical Assessment and Research Centre: from ‘medicine for football’ to ‘football for health’. Br J Sports Med 49: 561 – 563, 2015. (Impact factor: 5.025)

Mannion AF, Impellizzeri FM, Naal FD and Leunig M. Women demonstrate more pain and worse function before THA but comparable results 12 months after surgery. Clin Orthop Relat Res 473 : 3849 – 3857, 2015. (Impact factor: 2.765) Marks M, Vliet Vlieland TP, Audigé L, Herren DB, Nelissen RG and van den Hout WB. Healthcare costs and loss of productivity in patients with trapeziometacarpal osteoarthritis. J Hand Surg Eur Vol 40 : 927 – 934, 2015. (Impact factor: 2.037) Silvers-Granelli H, Mandelbaum B, Adeniji O, Insler S, Bizzini M, Pohlig R, Junge A, Snyder-Mackler L and Dvořák J. Efficacy of the FIFA 11+ injury prevention program in the collegiate male soccer player. Am J Sports Med 43: 2628 – 2637, 2015. (Impact factor : 4.362) Staub LP, Ryser C, Röder C, Mannion AF, Jarvik JG, Aebi M, and Aghayev E. Total disc arthroplasty versus anterior cervical interbody fusion: use of the spine tango registry to supplement the evidence from RCTs. Spine J (Epub ahead of print) DOI: 10.1016 / j. spinee.2015.11.056, 2015. (Impact factor: 2.426)

Impellizzeri FM, Mannion AF, Naal FD and Leunig M. Validation of the Core Outcome Measures Index in patients with femoroacetabular impingement. Arthroscopy 31 : 1238 –1246, 2015. (Impact factor : 3.206) Mannion AF, Fekete TF, Wertli MM, Mattle M, Nauer S, Kleinstück FS, Jeszenszky D, Haschtmann D, Becker HJ, Porchet F. Could less be more when assessing patient-rated outcome in spinal stenosis ? Spine (Phila Pa 1976) 40 : 710 – 718, 2015. (Impact factor: 2.297)

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Current and completed projects In the service of health

Return to sport after hip surgery for femoroacetabular impingement: a systematic review; Casartelli NC, Leunig M, Maffiuletti NA, Bizzini M (Teaching, Research and Development, Human Performance Lab, Schulthess Clinic) Femoroacetabular impingement (FAI) is a hip pathology that is suffered by many athletes and that can lead to functional limitations during sporting activities. Hip surgery is often performed in order to treat symptomatic FAI. The return to sport is of particular importance to competitive athletes who are affected. In this study, we conducted a systematic review of the relevant scientific literature in order to record the number of athletes returning to sport after the surgery. A total of 18 studies and 977 athletes were included in this systematic review. On average, 87 % of the athletes returned to sport and 82 % achieved the same level of sport as before the occurrence of symptoms. Professional athletes seem to return to sport after hip surgery at a higher rate compared with recreational athletes. However, professional athletes’ participation in sporting activities tends to decrease in the early years following the operation. Moreover, the return to sport is not always associated with a return to the athletes’ effective sporting capabilities. This systematic review therefore demonstrated (1) that the majority of athletes return to sport after FAI surgery to treat FAI, (2) that the athletes’ performance level can have an influence on the return to sport, and (3) that the return to sport cannot be used as the only determinant for evaluating the success of hip surgery. Recovery of hip, knee and ankle muscles after total hip arthroplasty; Friesenbichler B, Casartelli NC, Wellauer V, Item-Glatthorn JF, Ferguson S, Maffiuletti NA (Teaching, Research and Development, Human Performance Lab, Schulthess Clinic) Patients suffering from hip osteoarthritis and concomitant pain are limited in their physical activity levels, which, over the duration of months and years, may lead to lower limb muscle atrophy. To quantify to which degree the lower limb muscles recover after total hip arthroplasty, we conducted a study within the LifeLongJoints (www.lifelongjoints.eu) project, including 21 patients suffering from unilateral hip osteoarthritis. Hip, knee and ankle strength measurements were conducted before and again 6 months after surgery. We showed that maximal hip flexor strength (–15 %) and hip extensor strength (–13 %) of the affected limb was significantly lower compared to the healthy limb before surgery, while no differences were found for knee and ankle muscles. In addition, we quantified the rate of force development, which indicates how quickly a muscle can generate force, and found lower rates in hip flexors (–31 %), hip adductors (–19 %) and knee extensors (–24 %) in the involved limb before surgery. About 6  months after surgery, both limbs showed similar maximal strength and rate of force development, with exception of the hip flexor of the operated limb, for which lower maximal strength persisted (–13 %). The results indicate a successful muscular recovery after total hip arthroplasty when using the minimally invasive anterior approach, while hip flexors should be specifically strengthened during the rehabilitation phase (Fig.1).

94

Current and completed projects

A selection of our research projects demonstrates our broad range of knowledge for the clinical treatment of patients.

Fig. 1

Fig. 2

Prevalence and functional consequences of femoroacetabular impingement in young male ice hockey players; Brunner R, Maffiuletti NA, Casartelli NC, Bizzini M, Sutter R, Pfirrmann CW, Leunig M (Teaching, Research and Development, Human Performance Lab, Schulthess Clinic) Femoroacetabular impingement (FAI) is highly prevalent in male ice hockey players. However, it was previously not clear whether FAI-related bony deformities have clinical consequences in terms of hip muscle strength, hip range of motion and on-ice physical performance. In this study, a total of 74 young male ice hockey players were evaluated for hip internal rotation using a purpose-built hip examination chair (Fig. 2). Only the hip with less internal rotation mobility was then tested further. First of all, the hip was investigated for possible FAI with the help of magnetic resonance imaging (MRI). In a blind study, the person conducting the investigation then performed the flexion / adduction / internal rotation (FADIR) provocation test and asked about hip pain during physical activity. If both findings were positive, the hip was classified as symptomatic. The following tests were also performed on all volunteers: (1) the strength in all hip muscle groups was measured unilaterally using a dynamometer, (2) the hip range of motion was measured unilaterally in all directions using the hip chair and a goniometer, and (3) on-ice ability in terms of acceleration, speed and agility was measured using photocells. Twenty-four (24) players showed no signs of FAI. FAI was diagnosed by MRI in 50 players, of whom 16 were symptomatic. No significant differences in terms of hip muscle strength, hip range of movement or on-ice physical performance were found between players with no signs of FAI, symptomatic and asymptomatic players with FAI. Although a high prevalence of FAI was demonstrated amongst young male ice hockey players, the morphological changes at this age have no consequences in terms of hip muscle strength, hip range of motion or on-ice physical performance.

Fig. 1 Hip flexor strength should be specifically trained in patients recovering from total hip arthroplasty. Fig. 2 Hip examination chair for measuring hip internal rotation

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Validation of the core outcome measures index in patients with femoroacetabular impingement; Impellizzeri FM, Mannion AF, Naal FD, Leunig M (Teaching, Research and Develpment, Lower Extremity Orthopaedics, Schulthess Clinic) To evaluate a short, hip-oriented outcome instrument, based on the Core Outcome Measures Index (COMI), in patients undergoing surgery for femoroacetabular impingement (FAI). The following full-length questionnaires were completed preoperatively and at 6 and 12 months postoperatively by 159 consecutive FAI patients: Hip Outcome Score (HOS); Oxford Hip Score; Western Ontario and McMaster Universities Arthritis Index; Short Form 12 Health Survey; World Health Organization Quality of Life questionnaire, short version; and EuroQol-Five Dimensional index. The scores for the 6 hip-oriented Core Outcome Measures Index (COMI-Hip) items – adressing pain, function, symptom-specific well-being, quality of life, and disability-were extracted from established full-length questionnaires, and their performance as an index was compared with that of the full-length instruments. Scores for the single items of the COMI-Hip questionnaire correlated well with the scores for the corresponding full-length instruments from which they were extracted (r = – 0.89 to – 0.62, P < .001). The COMI-Hip sum score also correlated well with the Oxford Hip Score and the Western Ontario and McMaster Universities Arthritis Index pain and function scores (r = – 0.85 to – 0.70, P < .001), as well as with the HOS (r = – 0.72 to – 0.60,

96

Current and completed projects

Preferred patient-rated outcome measure in patients with femoroacetabular impingement: a comparison between selected instruments; Impellizzeri FM, Naal FD, Mannion AF, Leunig M (Teaching, Research and Develpment, Lower Extremity Orthopaedics, Schulthess Clinic) The first aim of this study was to establish which questionnaire patients with femoroacetabular impingement (FAI) most often preferred out of a set of self-reported generic and region / joint-specific outcome measures. A second aim was to evaluate their preferred type of response scale. One hundred and sixty-two consecutive FAI patients undergoing surgery (51 % females, age 32 [SD 12] years, body mass index 24 [SD 4] kg /m 2) completed five specific questionnaires [Hip Outcome Score (HOS), Oxford Hip Score (OHS), Hip disability and Osteoarthritis Outcome Score, self-administered Harris Hip Score and Western Ontario and McMaster Universities Arthritis Index] and three generic questionnaires (WHO Quality of Life-BREF, EuroQoL and 12-Item Short Form Survey). In addition, the patients completed the International Physical Activity Questionnaire, a questionnaire on expectations and two sports activity scales (TEGNER and UCLA). Patients were asked to indicate the questionnaires that best reflected their situation, the most difficult to complete, and had the preferred response scale. 64 % indicated a joint specific questionnaire as the one that best addressed their situation, with 27 and 20 % choosing the HOS and the OHS, respectively. Most patients (62 %) expressed no difficulties completing the questionnaires: just 12 % considered the IPAQ difficult to complete, and 6 % the HOS. The preferred response scale was the adjectival scale (57 %), compared with the Numeric Rating Scale (39 %) and the VAS (4 %). This study showed that patients with FAI consider joint-specific instruments to be most relevant to them, in particular the HOS and OHS, and generally prefer responding on an adjectival scale.

P < .001), an instrument specifically developed for assessing FAI patients. Internal responsiveness (Cohen’s d for effect size) of the COMI-Hip sum score from preoperatively to 12 months postoperatively was similar to that of the HOS activities-of-daily living subscale (d = – 0.76 and d = – 0.68, respectively; P < .001). Significant correlations were found between the change scores of the COMI-Hip sum score and those of the HOS activities-of-daily living and sport subscales at 6 months (r = – 0.62 and r = – 0.60, respectively; P < .001) and 12 months (r = – 0.69 and r = – 0.61, respectively; P < .001), showing the external responsiveness of the COMI-Hip. The COMI-Hip is a simple yet valid and responsive outcome instrument for the efficient assessment of patients undergoing surgery for FAI. It performs at least as well as the current reference instrument for FAI, the HOS, and can therefore be considered a potentially valuable instrument for routine use in both research and clinical practice. Risk of insufficient internal rotation after bilateral reverse shoulder arthroplasty: clinical and patient-reported outcome in 57 patients; Wirth B, Kolling C, Schwyzer HK, Flury M, Audigé L (Teaching, Research and Develpment, Upper Extremity Orthopaedics, Schulthess Clinic) Bilateral reverse shoulder arthroplasty (RSA) is controversial because of potential rotational deficits impairing daily living activities. We assessed achievement of insufficient internal rotation (IR) and associated factors in bilateral RSA patients. Fifty-seven staged bilateral RSA patients with a minimum of 1  year of follow-up after the second intervention were identified from our local monocentric register. Shoulder range of motion (including IR using the Apley scratch test), strength, and Constant and Shoulder Pain and Disability Index scores were assessed preoperatively and 6, 12, and 24 months postoperatively. Before surgery, both shoulders were similar regarding imaging parameters, but first operated shoulders tended to have poorer function. One year after the first RSA, 21 % of patients had insufficient IR (not reaching the lumbosacral junction) compared with 33 % after the second intervention (P = 0.180). At 2 years, 5 % of patients had insufficient IR on both sides. Patients with insufficient IR on the second side at baseline (relative risk [RR], 1.8 [1.0–3.2]) and patients with insufficient IR 1 year after the first RSA (RR, 3.0 [1.6–5.6]) were more likely to have insufficient IR 1 year after the second RSA. Constant and Shoulder Pain and Disability Index scores and abduction of the second side were significantly worse 1 year after the second RSA (P ≤ 0.047); at 2 years, there were no differences in functional outcome between shoulders. A minority of bilateral RSA patients did not achieve sufficient IR on at least 1 side. Staged surgery is justified, particularly when the outcome of the initial operation is satisfactory.

97

Complications associated with arthroscopic rotator cuff tear repair (ARCR): definition of a core event set by Delphi consensus process; Audigé L, Flury M, Müller AM, ARCR Consensus Panel, Durchholz H (Teaching, Research and Develpment, Upper Extremity Orthopaedics and Hand Surgery, Schulthess Clinic) The literature does not consistently report on complications associated with arthroscopic rotator cuff repair (ARCR). Valid comparison of the occurrence of complications between ARCR interventions requires standardization. This project was implemented to define a core set of negative events associated with ARCR along with their terms and definitions, which should be systematically documented and reported in routine care and clinical research. A Delphi consensus process was applied with an international panel of experienced shoulder surgeons nominated through professional societies and personal contacts. Based on a systematic review of terms and definitions, an organized list of relevant events associated with ARCR was developed and reviewed by panel members. Between each survey, all comments and suggestions were considered to revise the proposed core set including local event groups along with definitions, specifications and timing of occurrence. Consensus was defined as at least a two-third agreement. Three successive online surveys were implemented involving 84  surgeons. Consensus with over 86 % agreement was reached for a core list of local events including three intraoperative (device, osteochondral, soft tissue) and nine postoperative event groups (device, osteochondral, pain, rotator cuff, surgical site infection, peripheral neurological, vascular, superficial soft tissue, deep soft tissue). Experts agreed on a time period for documentation for each event or group of events ranging from 3 to 24 months after ARCR. This structured core set of local events associated with ARCR developed by international consensus requires further evaluation and validation in the context of clinical studies. Evaluation of expectations and expectation fulfilment in patients treated for trapeziometacarpal osteoarthritis; Frouzakis R, Herren D, Marks M (Teaching, Research and Development, Upper Extremities and Hand Surgery, Schulthess Clinic) The aim of this study was to analyse the pre-treatment expectations of patients with trapeziometacarpal osteoarthritis (Fig. 3) and to determine whether these expectations were fulfilled one year after treatment. A total of 163 patients who were treated for trapeziometacarpal osteoarthritiseither surgically or by means of corticosteroid injections were included in the study. Prior to treatment, 65 % of the patients stated that their main expectation of the treatment was pain reduction. Other expectations were improvement of hand function (17 %), return of the capabilities to perform the activities of daily living (13 %), improved strength (3 %) and return to work (2 %). After one year, 77 % of the patients treated surgically stated that their expectations had been fulfilled, compared with just 24 % of the patients treated with corticosteroid injections. The reduction in pain after an injection generally only lasts in the short- to medium-term, meaning that these patients were often once again experiencing pain after one year and were therefore not satisfied with the outcome of their treatment. In the interests of a high level of patient satisfaction, it is therefore important to assess patients’ pre-treatment expectations precisely and to explain in detail to patients the treatment outcomes which can realistically be achieved.

98

Current and completed projects

Fig. 3

Pessimistic back beliefs and lack of exercise: a risky combination for future shoulder, neck, and back pain; Mannion AF, Müller U (Bern), Rolli C (Bern), Tamcan O (Bern) (Teaching, Research and Develpment, Spinal Surgery and Neurosurgery, Schulthess Clinic) Pessimistic beliefs regarding the inevitability of the future as a consequence of having back trouble are associated with pain maintenance, absence from work and increased use of the healthcare system. However, most studies in this area have been cross-sectional, making it difficult to distinguish cause from effect (what came first, the negative beliefs or the pain ?). We carried out a prospective study to assess whether scores on the Back Beliefs Questionnaire (BBQ) were able to predict future pain. A questionnaire booklet was completed by 2507 individuals who had participated in an earlier population survey of musculoskeletal health; 1833 returned a follow-up questionnaire 1 year later. At baseline, we asked them if they had back pain at the time of completing the survey and if they currently exercised. At baseline and 1 year later we asked them to complete the BBQ and to rate how much pain they experienced in the left / right shoulders, neck / upper back and lower back during the prior 4 weeks. We used structural equation modeling to evaluate the associations between baseline BBQ and 1-year pain scores. Back beliefs were found to predict future pain and had the greatest predictive strength in individuals who reported back pain at baseline and did not exercise. In patients who had back pain at baseline, but who exercised, the risk of their back beliefs influencing future pain levels was diminished. We suggest that educational interventions addressing pessimistic back beliefs might reduce the risk of developing persistent pain in high-risk groups, such as those experiencing back pain who are not regular exercisers.

Fig. 3 Trapeziometacarpal osteoarthritis

99

10.0 8.0 6.0 4.0 2.0

Number of points

0 DH

DS COMI

SS

Preop. women

DH

DS SS Back pain intensity

Preop. men

DH

DS SS Leg pain intensity

DH DS SS DH DS SS Dominant pain Functional capability intensity Back or legs

Women, 1 year postop.

DH DS SS Symptom-specific state

DH DS SS Quality of life

DH

DS SS Limitation

Men, 1 year postop.

Influence of gender on patient-oriented outcomes in spine surgery; Pochon L, Kleinstück F, Porchet F, Mannion AF (Teaching, Research and Develpment, Spinal Surgery and Neurosurgery, Schulthess Clinic) Few studies have examined gender differences in self-reported health-related quality of life before and after spine surgery. This study examined the influence of gender on baseline status and 1-year postoperative outcomes in 1518 patients (812 men and 706 women; mean (SD) age 61.4 ± 16 years) undergoing surgery for different degenerative spinal disorders (disc herniation, degenerative spondylolisthesis, or spinal stenosis). Before and 12 months after surgery, patients completed the multidimensional Core Outcome Measures Index (COMI) (measures pain, function, quality of life, etc). Medical history and surgical details were documented with the EUROSPINE “Spine Tango” Surgery form. Before surgery, women had significantly (p < 0.05) worse COMI scores than men, indicating a worse status in women. However, the improvement in COMI score 12 months after surgery was similar for men and women. 71 % males and 73 % females achieved a score-change on the COMI that was large enough to be considered “clinically important” (i. e. a reduction of at least 2.2 points on the 10-point scale) (Fig. 4). Adjusting for potential confounders (preoperative COMI, comorbidity, complications, type of disorder), gender still did not influence whether this score-change was achieved or not. The results indicate that, although they present with a worse preoperative status, women do not differ significantly from men regarding their postoperative outcome. The management of a patient’s condition should not be influenced by their gender, since men and women are able to improve to a similar extent. Age and genetics influence adjacent segment disc degeneration more than fusion in patients treated for chronic low back pain; Omair A (Norway), Mannion AF (Schulthess Clinic), Leivseth G (Norway), Fairbank J (Great Britain), Holden M (Norway), Hägg O (Sweden), Fritzell P (Sweden), Bros JI (Norway) (Teaching, Research and Development, Spinal Surgery and Neurosurgery, Schulthess Clinic) There is ongoing debate as to whether fusion of a segment of the spine results in accelerated degeneration of the neighbouring segment (due to increased mechanical stress) or whether it is instead determined by personal factors such as age and genetics. We sought to investigate this in 285 patients,13 ± 4 years after they had been randomized to receive either spinal fusion or non-operative treatment for chronic low back pain. Disc space height was measured from standing plain X-rays, using a validated technique, to indicate disc degeneration. Genetic association analyses were carried out for 25 genes relevant to disc degeneration. In multivariable regression analysis (including the independent variables age, gender, smoking, duration of follow-up, fusion / no fusion, and genetic factors) about one quarter of the total variance in disc space height could be accounted for; genetics, age and fusion contributed 45 %, 45 % and 7 %, respectively (3 % other factors). Age and genetic factors (in particular inflammatory genes) were hence the most significant determinants of adjacent segment disc space height. Fusion explained a statistically significant but small proportion of the total variance. Much of the variance remained to be explained. Other determinants, such as body mass index or gene-environment interactions may be important to consider in future studies.

100

Current and completed projects

Fig. 4

Fig. 5

Fig. 6

Fig. 7

Prevention of football injuries in children: FIFA 11+ Kids; Faude O, Rössler R, Bizzini M, Dvořák J, Chomiak J, aus der Fünten K, Verhagen E, Lichtenstein E, Junge A (Teaching, Research and Development, F-MARC, Schulthess Clinic), in cooperation with Department of Sport, Exercise and Health, University of Basel, Switzerland; Department of Orthopaedics, Faculty of Medicine, Charles University and Hospital, Prague, Czech Republic; Institute for Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany; Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands) While several studies on injuries and their prevention in youth and adult football players were published, such research was lacking for children. Therefore, F-MARC conducted a prospective epidemiological study in kids (aged 7 to 12 years) playing football in the Czech Republic and Switzerland. The results allowed a better understanding of the specific injury characteristics in children’s football, such as a relatively high proportion of bone fractures and of upper limbs injuries (due to falls). Based on the results of this epidemiological study F-MARC, together with an international group of experts, adapted it’s injury prevention programme for children. The “FIFA 11+ Kids” is 15 minutes warm-up which consists of 7 exercises each in 5 levels of difficulty. In a large multi-centre intervention study (RCT) in four European countries involving about 4000 kids, it was shown that teams performing “FIFA 11+ Kids” had significantly (about 50 %) fewer injuries than teams not performing the programme. Consequently, FIFA and F-MARC will promote and disseminate its new injury programme for children world-wide (Fig. 5– 7).

Fig. 4 Average COMI scores for men and women preoperatively and one year postoperatively for the three different pathologies investigated DH = disc herniation DS = degenerative spondylolisthesis SS = spinal canal stenosis Fig. 5 –7 Exercises from the “FIFA 11 + Kids” programme

Long-term health problems in former elite female football players; Prien A, Prinz B, Dvořák J, Junge A (Teaching, Research and Develpment, F-MARC, Schulthess Clinic, in cooperation with Medical School Hamburg (MSH), Hamburg, Germany) While many studies have investigated injuries in active football players, very few have evaluated the long-term health consequences of a professional football career, particularly in female football. Thus, 245 former first German league players female football players who played at least three matches in the first German league or for the National team between 2000 and 2013 were asked to answer an anonymous online survey on current physical complaints (PC), subjective health, medication use, diagnosis of Osteoarthritis (OA) and artificial joint replacement (response rate: 62.0 %; aged on average 33 years). Around 70 % of the former players described their current health (on average 6.8 years after the end of their professional career) as good or very good. More than 50 % reported knee problems during the last four weeks while exercising, and a third during normal daily activities. Almost one quarter (23.7 %) of players suffered from OA. Regression analysis showed that OA in knee / ankle and other PC in knee / ankle / head were significantly predicted by number and severity of previous injuries. Further, older age, higher training volume and level of play were associated with an increased likelihood of OA, but not of PC. In conclusion, German former elite female football players reported a higher prevalence of PC and OA in knee and ankle, poorer subjective health, and increased pain medication use compared to the general population.

101

102

Current and completed projects

Mental health of male and female Swiss top-level football players; Feddermann-Demont N, Junge A (Teaching, Research and Develpment, F-MARC, Schulthess Clinic, in cooperation with Department of Neurology, Interdisciplinary Center for Vertigo and Neurological Visual Disorders, University Hospital Zurich, Medical School Hamburg (MSH), Hamburg, Germany) Since scientific studies on the prevalence of mental health problems in elite athletes are rare, we asked all male and female teams of the Swiss first league (FL) and four U-21 football teams to anonymously answer a well-established questionnaires on depression and anxiety as well as questions on player characteristics. All total of 471 football players took part in the study. Based on the standardised questionnaires 33 (7.6 %) players had a mild to moderate, 13 (3.0 %) a major depression, and six (1.4 %) players an at least moderate anxiety disorder. Compared to the general population the prevalence of depression was similar and the prevalence of anxiety disorders was significantly lower in football players. However, symptoms of a severe depression were present in on average one player of each female FL team and one of each male U-21 team, as well as in one player in two male FL teams. Significant differences were observed with regard to player characteristics, such as age, gender, player position, level of play, current injury. It is important to raise awareness and knowledge of athletes’ mental health problems in coaches and team physicians, and to provide adequate treatment to athletes.

103

Balance Sheet, Income Statement and Statistics

Balance Sheet, Income Statement and Statistics

Table of contents Annual Report 2015

Annual accounts 2015 Clinic income statement Foundation income statement Balance sheet Notes as at 31 December 2015 Disclosures, breakdowns and explanations Auditor’s report

106 107 108 110 111 112

Statistics Key figures Average length of stay in days No. of inpatient cases by specialist discipline Patient origin

114 114 114 115

Donations and acknowledgements

117

Donations

Diagnoses and surgical interventions Inpatient diagnoses Outpatient diagnoses Surgical interventions

118 120 121

105

Annual accounts Clinic income statement

2015

2014

CHF

CHF

145 815 123 1 973 269 33 335 630 295 000 1 527 711 182 946 734

147 004 402 2 439 452 32 374 474 210 000 1 380 723 183 409 051

– 167 906 –167 906

– 503 597 – 503 597

– 35 359 999 – 35 359 999

– 30 688 280 – 30 688 280

– 72 212 596 –19 079 226 – 20 209 145 –111 500 967

– 65 625 155 –19 822 445 –16 392 796 –101 840 396

– 872 602 –1 721 406 – 6 171 276 – 854 193 –1 567 655 –1 839 442 – 6 300 045 – 3 219 411 – 22 546 029

– 2 326 073 –1 542 144 – 4 424 116 – 699 758 –1 465 195 –1 363 029 – 5 172 573 – 2 826 214 –19 819 102

Write-offs Other depreciation Depreciation and value adjustments to capital assets

– 8 341 374 – – 8 341 374

– 7 727 400 –13 000 000 – 20 727 401

Financial expenditure Interest expenses Interest on state loans Capital costs

–1 047 044 – 374 002 – 4 363 223

– 633 776 –705 274 – 4 605 209

Financial income Income from interest Financial expenditure and income

845 – 5 783 424

2773 – 5 941 486

– 752 967

3 888 790

Net revenue from goods and services Inpatient services Partial inpatient services Outpatient services Subsidies from Canton of Zurich Dept. of Health Other income Net revenue from goods and services Inventory change for unbilled services Inventory changes and unbilled services Medical supplies Cost of materials Staff costs Salaries and wages Fees Social security contributions and additional staff expenses Staff costs

Facts and Figures

Food costs Housekeeping costs Maintenance and repairs Use of installations Power supply costs Rental and leasing costs Office and administrative costs Insurance and other costs Other operating costs

Annual profit / loss for Clinic

106

Foundation income statement

2015

2014

CHF

CHF

166 206 4 113 557 296 183 6 336 699 192 440 312 863 11 417 948

756 079 3 666 112 7 389 304 6 117 368 205 483 335 330 18 469 676

Foundation expenditure Investment in funds Support and contributions Expenditure, subsidiary operations Expenditure, real estate Other expenses Foundation expenditure

– 296 183 – 4 113 557 – 8 603 304 –190 269 –1 109 960 –14 313 273

– 7 391 904 – 9 666 112 – 6 404 766 – 204 139 – 77 663 – 23 744 583

Financial expenditure Securities expenses Interest expenses

– 2 052 854 –11

– 494 131 –

1 944 683 4 327 289 4 219 107

1 977 189 4 606 430 6 089 488

–15 685 20 420 4735

– 31 305 5841 – 25 464

– 8 123 301 6 218 316 –1 904 985

– 63 327 552 532 489 206

– 576 467

1 278 322

–1 329 434

5 167 113

Foundation income Donations Withdrawals from funds Various income, funds Income, subsidiary operations Income, real estate Other income Foundation income

Financial income Income from securities Income from interest Financial expenditure and income Non-operating expenditure and income Non-operating expenditure Non-operating income Non-operating expenditure and income Extraordinary expenditure and income Extraordinary expenditure Extraordinary income Extraordinary expenditure and income Annual profit / loss for Foundation Annual result for Wilhelm Schulthess Foundation

107

Annual accounts Balance sheet Assets

31 December 2015

31 December 2014

CHF

CHF

32 677 186 37 207 459

56 504 241 35 719 129

39 701 370 197 151 1 500 088

39 353 967 382 614 847 194

1 944 019

2 763 009

6 248 539 446 324 2 410 788 122 332 924 39 %

5 194 091 614 230 766 981 142 145 455 47 %

45 463 295 143 785 010 1 142 570

38 063 117 117 218 212 771 548

1 784 343 192 175 218 61 %

2 740 258 158 793 135 53 %

314 508 142

300 938 590

Current assets Liquid funds and short-term assets with a stock market price Liquid funds Securities Trade receivables Patients and guarantors Third parties Canton of Zurich Dept. of Health Other short-term receivables Third parties Stock and unbilled services Goods in stock Unbilled services Prepaid expenses and deferred charges Total current assets as a % of the balance sheet total Capital assets Tangible assets Operating equipment Real estate Lengg Other real estate Intangible assets IT: software and licences Total capital assets as a % of the balance sheet total

Facts and Figures

Total assets

108

Balance sheet Liabilities Short-term outside capital Trade payables Third parties Other current liabilities Third parties Patients and staff Pool accounts and current accounts Accrued expenditures and deferred income Total short-term outside capital as a % of the balance sheet total

31 December 2015

31 December 2014

CHF

CHF

6 606 576

4 848 602

7 363 879 115 748 8 211 637 6 216 916 28 514 756 9%

3 703 689 105 045 6 679 306 6 439 088 21 775 730 7%

Long-term outside capital Long-term interest-bearing liabilities Banks /mortgages Credit from the Canton of Zurich Dept. of Health Other long-term liabilities Credit from the City of Zurich Provisions Total long-term outside capital as a % of the balance sheet total

40 000 000 21 371 549

30 000 000 21 371 549

2 080 558 92 246 102 155 698 208 50 %

2 080 558 90 305 439 143 757 546 48 %

Total outside capital as a % of the balance sheet total

184 212 965 59 %

165 533 276 55 %

Equity Foundation capital Funds Voluntary retained earnings Free reserves Profit / loss carried forward Annual profit / loss Total equity as a % of the balance sheet total

14 327 384 26 160 285

14 327 384 29 940 987

73 488 603 17 648 340 –1 329 434 130 295 178 41 %

73 488 603 12 481 227 5 167 113 135 405 314 45 %

Total liabilities

314 508 142

300 938 590

109

Annual accounts Notes as at 31 December 2015

Basic principles used in these annual accounts These annual accounts were prepared in accordance with the provisions of Swiss accounting and reporting law (Section 32 of the Swiss Code of Obligations). The basic evaluation principles used that are not stipulated by law are outlined below. It is important to note that we are taking the opportunity to build up and release hidden reserves with a view to securing the organisation’s long-term prosperity. 2015 was the first year in which the annual accounts were prepared in accordance with the provisions of Swiss accounting and reporting law (Section 32 of the Swiss Code of Obligations). The figures from the previous year have been restated in line with the structure of these newly adopted accounting and reporting standards. Liquid funds and short-term assets with a stock market price Liquid funds comprise cash in hand, funds in post office and bank accounts and cash equivalents with a maturity of up to 90 days. They are stated at their nominal value. Securities are reported at their market value. If there is no current market value available, they are valued at no more than the acquisition cost less any depreciation. Unbilled services Services provided but not yet billed are generally reported at the value of the revenue they are expected to bring, i. e. at the invoice amount less any value adjustment necessary for business reasons. Services that have been partially rendered are generally valued on the basis of the proportional expected revenue attributable to the service already performed, i. e. at the proportional invoice amount less any value adjustment necessary for business reasons.

Facts and Figures

Goods in stock Goods in stock are stated at acquisition or production cost. Acquisition or production costs comprise all direct and indirect expenditures involved in bringing the goods to their current location (full costs). The average cost method is used. Discounts are deducted directly from the acquisition costs. Value adjustments are made if the net realisable value is less than the acquisition costs or if the goods have become obsolete. Tangible assets Tangible assets are valued on the basis of their acquisition or production costs, less any accumulated depreciation and value adjustments. With the exception of land, tangible assets are depreciated on a straight-line basis. If there are any signs of overvaluation, the book values are checked and adjusted if necessary.

110

Disclosures, breakdowns and explanations

Other short-term receivables Other short-term receivables mainly consist of pension and personal insurance premiums paid out in advance. Prepaid expenses and deferred charges Prepaid expenses and deferred charges include prepaid invoices for services to be provided in the following year. These comprise insurance premiums in particular in the year under review. Tangible assets Tangible asserts include construction in progress valued at CHF 92 million. This mostly relates to the new building extension, which is not yet fully operational. Other current liabilities Current liabilities to third parties primarily consist of invoices relating to Old Age and Survivors Insurance (OASI), withholding tax and other insurance providers that were received before the balance sheet date. Accrued expenditures and deferred income Accrued expenditures and deferred income essentially consist of accruals and deferrals for rates that have not yet been definitely set, contractually agreed remuneration for services rendered and various invoices for services provided in the year under review where the invoice was not received until the following year. Provisions The provisions relate primarily to the new building work, IT infrastructure, pending legal cases and obligations to staff such as holiday and overtime entitlements, rewards for length of service and early retirement opportunities. Extraordinary expenditure Extraordinary expenditure mainly comprises expenses relating to negotiations with insurers over the past year that have not yet been concluded and exceptional write-downs concerning pool accounts. Extraordinary income Extraordinary income includes the release of provisions no longer needed as of the balance sheet date. Additional disclosures Net release of hidden reserves Liabilities to provident institutions Number of full-time positions Borrower’s notes Real estate: Lengghalde 2, Zurich (hospital building) Real estate: Lengghalde 2, Zurich (hospital building) Guarantees ZKB guarantee for leases Contingent liabilities BVK pension fund cover shortfall

2015 0 0 > 250

2014 0 1 044 318 > 250

40 000 000 2 080 600

40 000 000 2 080 600

290 000

290 000

5 069 122

829 527

Events after the balance sheet date At the time of approval of these annual accounts by the Board of Trustees, no significant events were known to have occurred that could influence the 2015 annual accounts.

111

Facts and Figures

Auditor’s report

112

113

Statistics A selection of relevant statistics from the Clinic’s activities Key figures

2011 Number of beds 160 Total no. of discharges 7 485 Outpatient and inpatient operations 8 615 No. of nursing days 50 020 Average length of stay (in days) 6.7 Patients with supplementary insurance (%) 54.3

2012 160 7 491 8 712 51 357 6.9 53.8

2013 160 7 543 8 741 50 691 6.7 52.5

2014 166 7 696 8 861 52 926 6.9 52.8

2015 166 7 983 8 976 55 188 6.9 49.3

Average length of stay in days No. of days

0

2

4

6

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Facts and Figures

No. of inpatient cases by specialist discipline Lower Extremities Spine Surgery and Neurosurgery Upper Extremities Foot and Ankle Surgery Hand Surgery Paediatric and Adolescent Orthopaedics and Deformity Correction

114

8

10

8.2 8.0 7.2 7.0 6.8 6.6 6.7 6.9 6.7 6.9 6.9

2014 2 841 1 234 1 683 1 265 289 203

2015 3 046 1 401 1 592 1 358 310 258

Patient statistics according to origin 2015 Origin

Canton of Zurich (excl. City) City of Zurich Aargau St. Gallen Ticino Thurgau Schwyz Graubünden Lucerne Zug Schaffhausen Glarus Bern Solothurn Valais Uri Basel-Landschaft Vaud Obwalden Basel-Stadt Nidwalden Appenzell AR Geneva Fribourg Appenzell AI Neuchâtel Jura Other countries incl. Liechtenstein Total

Patients

Nursing days

Days in %

3 520 1 239 804 284 284 256 233 170 150 146 123 113 81 80 65 42 38 33 27 26 18 14 13 11 5 3 3

23 602 8 666 5 360 1 994 1 969 1 893 1 585 1 200 1 012 1 243 777 831 587 560 416 307 280 262 194 176 113 98 97 79 23 24 32

42.8 16.0 9.7 3.6 3.6 3.4 2.9 2.2 1.8 2.3 1.4 1.5 1.0 1.0 0.7 0.6 0.5 0.5 0.3 0.3 0.2 0.2 0.2 0.1 0.1 0.1 0.1

202

1 808

3.3

7 983

55 188

100.0

Nursing days according to origin From abroad 3 % City of Zurich 16 % Canton of Zurich (excl. City) 43 % Other cantons 38 %

115

Facts and Figures

Donations and acknowledgements

Donations and acknowledgements In 2015, numerous donors once again made significant contributions to the Wilhelm Schulthess Foundation as the sponsor of the Clinic or to one of the existing funds. This money helps the Foundation to further scientific research and development in the interest of medicine. The Board of Trustees and Clinic Directorate would like to extend their sincere thanks to all donors.

Donations for 2015 CHF

G. Steiger-Leutwyler, Oberwil b. Zug (bequest) A. M. Gerber Bretscher, Zollikerberg Elektro Compagnoni AG, Zurich R. Lehner, Zumikon (bequest) H. Kaiser, Zurich (bequest) H. Minder, Wil L. Peyer, Feldmeilen Dr. R. A. Eichler, Brugg E. Herrmann, Basel H.-J. Busenhart, Zurich A. K. Accad, Oberweningen Ch. Rösli, Zurich Donations less than CHF 100 Total donations

55 246 50 000 30 000 10 000 10 000 4 000 2 000 1 500 1 000 1 000 500 150 810 166 206

117

Inpatient diagnoses

Facts and Figures

Inpatient diagnoses Joint diseases Inflammatory diseases Arthritis, other 3 Psoriatic arthritis 10 Arthropathy with infection 5 Arthropathy, other induced by stones and crystals 26 Juvenile chronic polyarthritis 9 Chronic polyarthritis 154 Collagenosis 9 Monoarthritis 6 Other inflammatory rheumatic diseases 12 Primary osteoarthritis Osteoarthritis of the acromioclavicular joint 233 Osteoarthritis of the hip 638 Osteoarthritis of the elbow 7 Osteoarthritis of the finger (Bouchard’s and Heberden’s nodes) 62 Osteoarthritis of the foot / toe 60 Osteoarthritis of the knee 761 Osteoarthritis of the wrist 19 Osteoarthritis of the shoulder 93 Osteoarthritis with multiple joint involvement 17 Osteoarthritis of the carpometacarpal thumb joint 77 Osteoarthritis of the ankle 52 Uncovertebral osteoarthritis 14 Secondary osteoarthritis with deformity 1 after arthritis 1 after chondromalacia, chondrocalcinosis 22 after congenital dysplasia 63 after epiphysiolysis 2 after infection 4 after Legg-Calvé-Pethes disease 1 after poliomyelitis 3 after trauma 334 after uncertain aetiology 3 after previous surgery 7 contralateral joint 2 Ankylosis 8 Arthralgia 5 Arthrofibrosis 68

118

(Post-)traumatic arthropathy Acquired leg-length difference Restricted movement, contracture Chondromalacia patellae Chondropathy of the knee (femur, tibia, fibula) Coxa antetorta Coxa valga Coxa vara Deformity of the big toe, other Deformity of the hand / finger, other Acquired deformity of the ankle / foot Acquired deformity of the toes, other Digitus quintus varus (bunionette deformity) Digitus superductus (crossover toe) DISI deformity of the wrist Dorsal bunion Drop foot, dorsiflexor paresis Femoropatellar pain syndrome, anterior knee pain Floating cartilage Gait disorder, ataxia Joint effusion Genu recurvatum Genu valgum Genu varum Hallux rigidus Hallux valgus Recurrent hallux valgus Hallux varus Haemarthrosis Hammer toe Instability of the ankle (upper / lower ankle joints) Instability of a ray of the foot Pes planovalgus Claw toe Cruciate ligament lesion Pathological dislocation Habitual dislocation, subluxation Patellar dislocation, subluxation Meniscal lesion Periarticular calcification Pes cavo valgus (hindfoot deformity) Pes cavo varus (hindfoot deformity) Flat foot Synovial plica

18 21 9 73 116 3 1 1 1 2 3 7 51 5 1 1 29 35 157 6 4 2 29 33 112 471 8 1 1 226 14 1 29 27 323 10 29 46 474 1 7 23 3 147

Acetabular protrusion Swan-neck deformity, finger Collateral ligament lesion (knee) Other acquired malleolar or foot deformity Patellar damage, other Villonodular synovitis Valgus deformity of the ankle Valgus deformity of the toe Varus deformity of the toe

Congenital disorders Achondroplasia (chondrodystrophic dwarfism) Other congenital anomalies Vertebral arch anomaly Multiple anomalies Humerus, radial, ulnar aplasia Arnold-Chiari malformation Arthrogryposis Beals-Hecht syndrome (contractural arachnodactyly) Buford complex of the shoulder Chordoma Chromosomal anomaly Tarsal coalition (subtalar etc.) Congenital coxa antetorta Congenital coxa magna Congenital coxa retrotorta Congenital coxa valga Congenital coxa vara Joint dysplasia Hip dysplasia Patellar dysplasia Multiple exostosis Abnormality, development disorder of the brain Congenital genu valgum Congenital genu varum Hemivertebra with congenital scoliosis Congenital hallux valgus Hemihypertrophy Hemihypotrophy Dislocation of the hip Congenital hydrocephalus Hypoplasia Club hand

1 3 14 4 2 2 1 2 1 5 382

1 32 1 1 2 2 1 2 1 4 5 4 7 1 9 5 1 8 26 1 5 1 46 9 2 5 2 1 5 1 3 1

Congenital pes planovalgus Kyphoscoliosis Patellar dislocation Marfan syndrome Metric variation Os acromiale Accessory navicular bone Sesamoid bone (fabella) Os subfibulare Os tibiale externum Os trigonum Imperfect osteogenesis (brittle bone disease) Patella alta Patella baja Bipartite, tripartite patella Pes adductus (in-toeing) Pes calcaneus (club foot with sole facing forwards) Congenital talipes equinovarus (club foot with sole facing backwards) Congenital talipes equinus (drop foot) Pes excavatus (hollow foot, high-arched foot) Pes planus, pes transversoplanus (flat foot, fallen arch) Splay foot Pseudarthrosis of the clavicle Rotational deformity of the femur Congenital rotational deformity of the tibia, fibula Scoliosis Cleft vertebra, wedge-shaped vertebra Spina bifida Tethered cord, congenital diplomyelia Different shapes of the patella

Spine disorders Intervertebral disc degeneration Coccygodynia Herniated disc Dorsalgia Hypermobility Thoracic and /or lumbar instability Kyphosis Kyphoscoliosis Lumbago, lumbar pain

4 1 2 4 6 4 1 2 1 5 1 1 5 9 3 2 1 7 1 4 4 1 1 2 10 6 1 2 1 1 288

277 5 391 2 1 21 29 4 3

Lumbovertebral syndrome 2 Bekhterev’s syndrome, ankylosing spondylitis 2 Post-laminectomy syndrome 3 Pseudospondylolisthesis (degenerative spondylolisthesis) 245 Sacroiliac joint syndrome (SI syndrome) 1 SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis and osteitis) 1 Scoliosis 88 Spinal stenosis 698 Spondylarthropathy 204 Spondylodiscitis 3 Spondylolisthesis 32 Spondylolysis 14 Hyperostotic spondylosis, Forestier’s disease, DISH syndrome 1 Spondylosis 247 Cervical syndrome 2 Cervicobrachial syndrome 2 2278 Bone and cartilage disorders Chondromatosis 4 Epiphysiolysis 5 Exostosis 112 Idiopathic femoral head necrosis 38 Post-traumatic femoral head necrosis 6 Calcaneal spur 63 Pathological fracture, spontaneous fracture 36 Hip impingement, femoroacetabular impingement (FAI) 128 Aseptic bone necrosis 38 Bone necrosis after medical intervention 3 Post-traumatic bone necrosis 11 Other secondary bone necrosis 5 Bone cyst 81 Bone marrow oedema 3 Kienböck’s disease (lunatomalacia) 1 Köhler’s disease 1 Köhler-Freiberg disease 6 Osgood-Schlatter disease 2 Legg-Calvé-Pethes disease (juvenile aseptic bone necrosis) 6 Scheuermann’s disease (juvenile osteochondrosis deformans) 1 Juvenile osteochondrosis 2 Osteochondrosis dissecans 37

Osteoid osteoma Osteolysis Osteomyelitis Osteophyte Osteoporosis Pseudarthrosis Traumatised os trigonum, externum etc.

3 15 10 68 224 248 15 1 172

Soft tissue disorders Achillodynia 12 Insertional tendinosis 41 Baker’s cyst (popliteal cyst) 5 Ligament laxity 27 Bursitis 389 Coxa saltans (snapping hip syndrome) 3 Dupuytren’s contracture 15 Radial epicondylitis (tennis elbow) 5 Ulnar epicondylitis (golfer’s elbow) 2 Other soft tissue disorders 13 Fibromyalgia (generalised tendomyopathy) 18 Hypermobility 3 Impingement syndrome of the elbow 6 Impingement syndrome of the hand, finger 4 Impingement syndrome of the wrist 3 Impingement syndrome of the shoulder 420 Elbow instability 3c Hand instability 2 Wrist instability 2 Shoulder instability 62 Adhesive capsulitis 1 Ligamentum flavum cyst 16 Compartment syndrome, non-traumatic 2 Muscle hernia 5 Muscular weakness of uncertain aetiology 1 Muscular dystrophy, disuse atrophy, dysbalance 17 Muscle shortening 12 Myalgia, unclear 1 Myositis 4 Ankylosing scapulohumeral periarthritis 61 Peroneal tendon dislocation 4 Polymyalgia rheumatica 57 Rhabdomyolysis 2 Rotator cuff tear 739 Tendon rupture 501 Synovial cyst 31

119

Inpatient diagnoses / Outpatient diagnoses

Facts and Figures

Synovitis, tendosynovitis Calcific tendinitis Tendinitis Iliotibial band syndrome Non-infectious cyst (sebaceous cyst etc.)

Injuries and consequences of injury Whiplash injury Pelvic fracture Upper extremity fracture Shoulder girdle fracture Lower extremity fracture Spine fracture Multiple fractures, polytrauma Intracranial injury Complex injury involving multiple structures of the knee Kyphosis Dislocation Open wounds Acquired patella baja Bruising Blood vessel injury Sprain, strain, rupture, instability

225 67 3 62 2 2 848

1 6 190 51 229 58 2 1 407 2 239 8 6 15 2 1 128 2 345

Various Admissions for removal of osteosynthesis material 264 Internal disorders 7 141 Cardiovascular diseases 1 297 Nerve lesions 358 Neurological disorders 251 Psychological disorders, dependency and withdrawal syndromes 529 Other and additional diagnoses 3 103 12 943 Inpatient diagnoses 2015

120

27 256

Outpatient diagnoses Neurology Congenital deformities Osteoarthritis Inflammatory joint diseases Fractures Internal disorders Bone and cartilage disorders Nerve lesions and nerve injuries Neurological disorders Postoperative complaints (Post-)traumatic joint disorders Soft tissue disorders Spinal deformities (scoliosis, kyphosis, lordosis etc.) Spine disorders Other diagnoses

Rheumatology Congenital deformities Osteoarthritis Inflammatory joint diseases Fractures Internal disorders Bone and cartilage disorders Nerve lesions and nerve injuries Neurological disorders Postoperative complaints (Post-)traumatic joint disorders Soft tissue disorders Spinal deformities (scoliosis, kyphosis, lordosis etc.) Spine disorders Other diagnoses

29 114 12 51 110 1 039 683 71 113 139 259 22 2 292 683 5 619

15 763 147 43 29 1 429 35 1 63 168 422 13 1 542 400 5 070

Sports medicine Congenital deformities Osteoarthritis Check-up (sports medicine, general) Inflammatory joint diseases Fractures Internal disorders Bone and cartilage disorders Nerve lesions and nerve injuries Postoperative complaints (Post-)traumatic joint disorders Soft tissue disorders Spinal deformities (scoliosis, kyphosis, lordosis etc.) Spine disorders Other diagnoses

Outpatient diagnoses 2015 (conservative disciplines)

86 596 4 63 169 887 18 21 727 360 9 435 363 3738 14 427

Surgical interventions Surgical interventions Spinal column Individual interventions on 1317 patients Removal of Crutchfield clamp or or halo traction 2 Soft tissue excision, head 1 Decompressive craniectomy 2 Surgical interventions on cerebrospinal fluid system 1 Herniated disc surgery 1 064 Spinal canal decompression without fusion (incl. nerve root revision, decompressive ligament resection, intervertebral foramen decompression) 543 Spinal canal decompression with fusion 558 Epidural, extradural abscess removal 2 Reconstructive and plastic interventions (open and percutaneous vertebroplasty, laminoplasty, kyphoplasty, duraplasty, spongiosaplasty etc.) 825 Disc prosthesis 11 Vertebral prosthesis 4 Spine prosthesis removal (disc, nucleus, vertebra) 1 Corrective osteotomy 116 Cervical spondylodesis anterior 121 posterior 28 Thoracic and lumbar spondylodesis anterior 2 posterior 28 combined (PLIF / TLIF, lateral etc.) 401 with spinal deformity 51 Spondylodesis revision 141 Dural patch 9 Removal of osteosynthesis material 200 Tumour excision (extramedullary and intramedullary) 18 Pain pump (insertion, revision, removal) 3 Spinal cord stimulator (insertion, revision, removal) 14 Other interventions (vertebrectomy, decortication, ribs etc.) 207 4 353

Shoulder Individual interventions on 1422 patients Fracture reduction 30 Osteotomy 7 Osteosynthesis 3 Bone resection 17 Spongiosaplasty 29 Removal of osteosynthesis material 36 Syndesmoplasty for AC joint dislocation, open 11 AC joint resection, open 2 Exploratory arthrotomy 12 Open stabilisation 35 Artificial joint Hemiprosthesis 5 Total prosthesis 187 Replacement, revision 12 Removal 7 Synovectomy 13 Syndesmoplasty, capsuloplasty 6 Ganglion excision 2 Calcification removal 2 Rotator cuff reconstruction, open 14 Soft tissue intervention 178 Haematoma evacuation 3 Diagnostic arthroscopy 26 Therapeutic arthroscopy Acromioplasty 823 Coracoidplasty 2 Tuberculoplasty 14 AC joint resection 353 Os acromiale resection 2 AC joint stabilisation 22 Calcification removal 59 Bursectomy 393 Synovectomy 35 Arthrolysis 87 Labral debridement 47 Cartilage shaving 8 Stabilisation 72 Removal of floating cartilage 17 Limbus refixation 18 Partial limbus resection 5 Tenotomy, biceps tendon tenodesis 660 Ganglion excision 7

Rotator cuff reconstruction Rotator cuff debridement Removal of osteosynthesis material Irrigation drainage Microfractures

450 145 12 1 15 3 884

Individual interventions on 92 patients Upper arm Fracture reduction 37 Osteotomy 3 Osteosynthesis 4 Bone resection 14 Bone graft 18 Bone drilling 4 Removal of osteosynthesis material 47 Soft tissue intervention 4 131

121

Facts and Figures

Elbow Individual interventions on 114 patients Reduction 1 Exploratory arthrotomy 8 Interposition arthroplasty (sine-sine) 3 Artificial joint Total prosthesis 1 Prosthesis replacement 5 Revision 1 Prosthesis removal 4 Synovectomy 7 Syndesmoplasty, capsuloplasty 13 Ganglion excision 1 Epicondylitis surgery 4 Arthrolysis 6 Diagnostic arthroscopy 1 Therapeutic arthroscopy Synovectomy 12 Removal of floating cartilage 18 Debridement 11 Arthrolysis 13 Plica resection 23 Microfractures 4 Nerve decompression, nerve transfer 10 Soft tissue intervention 65 Haematoma evacuation 2 213 Individual interventions on 123 patients Lower arm Reduction 33 Osteotomy 9 Osteosynthesis 5 Bone resection 1 Exostosis removal 5 Ulnar head resection 4 Partial bone resection of the ulna 11 Kapandji-Sauvé procedure 3 Radial head resection 3 Partial bone resection of the radius 19 Bone graft 6 Bone drilling 2 Epiphysiodesis 3 Stabilisation of the ulnar head with transosseous TFCC refixation 2 Removal of osteosynthesis material 46 Soft tissue intervention 17 Tenosynovectomy 7 176

122

Wrist Individual interventions on 269 patients Reduction 1 Bone resection and interposition 1 Artificial joint Partial prosthesis 2 Total prosthesis 1 Proximal row carpectomy (PRC) 4 Arthrodesis 3 Panarthrodesis (Mannerfelt etc.) 2 Partial arthrodesis (carpal, intercarpal, carpometacarpal) 16 Synovectomy 28 Syndesmoplasty, capsuloplasty 4 Tumour excision 2 Ganglion excision 26 Osteosynthesis of carpal bones 5 Carpal bone graft 3 Carpal bone excision 2 Removal of osteosynthesis material 8 Diagnostic arthroscopy 4 Therapeutic arthroscopy CTS decompression 28 Microfractures 1 Operation on nerves Decompression, neurolysis, nerve suture 155 Vascular intervention 1 Operation on tendons Tenolysis, tendon suture 4 Tendon transplant 10 Tenodesis 1 Tenosynovectomy 53 Operation on annular ligaments 8 Soft tissue intervention 5 378

Hand Individual interventions on 438 patients Incision of annular ligament to treat congenital tendovaginitis 1 Reduction 18 Osteotomy 2 Exploratory arthrotomy 2 Bone resection with soft tissue interposition 1 Arthroplasty Epping suspension-plasty 107 MCP joint prosthesis 15 PIP joint prosthesis 63 DIP joint prosthesis 4 Prosthesis replacement 6 Prosthesis removal 2 Arthrodesis, hand 7 Arthrodesis, finger 69 Osteosynthesis 1 Bone resection 52 Bone graft 20 Synovectomy 13 Tenosynovectomy 81 Ligament suture, capsulorrhaphy 12 Tumour excision 2 Ganglion excision 18 Arthrolysis 17 Removal of osteosynthesis material 26 Operation on nerves Neurolysis, nerve suture 3 Neuroma or nerve tumour excision 1 Denervation 1 Vascular operation 1 Fasciectomy for Dupuytren’s contracture 45 Operation on tendons Tenolysis, tendon suture 14 Tendon transplant 11 Tenodesis 10 Operation on annular ligaments 139 Bone drainage Soft tissue intervention 43 Haematoma evacuation 1 Bone drainage 1 809

Pelvis, hip Individual interventions on 1365 patients Reduction 5 Osteotomy Salter osteotomy 1 Pemberton osteotomy 2 Triple osteotomy 1 periarticular osteotomy (PAO) 26 Osteosynthesis 1 Bone resection (bone chip harvesting from pelvis) 373 Coccygectomy 5 Bone graft 44 Bone drilling, drainage 15 Chondroplasty (AMIC), acetabulum 5 Removal of osteosynthesis material 12 Labral refixation (for offset disorder etc.) 40 Soft tissue intervention 60 Haematoma evacuation 2 Exploratory arthrotomy, drainage, debridement 4 Artificial joint Total prosthesis 795 Acetabular cup replacement 40 Stem replacement 17 Total prosthesis replacement 55 Prosthesis removal 19 Revision 24 Arthrodesis 1 Synovectomy 2 Syndesmoplasty, capsuloplasty 2 Ganglion excision 3 Removal of periarticular calcification 2 Capsulectomy 3 Labral shaving (for offset disorder etc.) 38 Arthrography 6 Arthrolysis 4 Therapeutic arthroscopy Labral refixation 51 Removal of floating cartilage 1 Synovectomy 8 Labral shaving, trimming (for offset disorder etc.) 63 Bone resection (femoral neck for offset disorder etc.) 63 Adhesiolysis 9 1 802

Thigh Individual interventions on 419 patients Reduction 36 Osteotomy subcapital 3 intertrochanteric 22 supracondylar 21 Desarthrodesis 6 Osteosynthesis 30 Bone resection (femoral neck for offset disorder etc.) 142 Decortication 4 Bone graft 65 Pridie drilling 28 Epiphysiodesis 72 Removal of osteosynthesis material 159 Trochleoplasty 1 Femoral chondrocyte transplantation (ACT I) 10 Cartilage fragmentation and transplantation, femur, knee 2 Soft tissue intervention 22 Haematoma evacuation 2 625 Individual interventions on 1759 patients Knee Exploratory arthrotomy 42 Ganglion, Baker’s cyst excision 14 Artificial joint Unicondylar prosthesis 67 Total prosthesis 765 Prosthesis replacement 133 Prosthesis revision 4 Prosthesis removal 24 Patellofemoral replacement 3 Patellar prosthesis 41 Arthrodesis 4 Synovectomy 77 Open cruciate ligament suture 7 Open collateral ligament suture 44 Open cruciate ligament replacement 6 Open collateral ligament replacement 1 Tumour excision 1 Ganglion excision 1 Bursectomy 4 Meniscectomy 1 Open meniscal suture 3 Cartilage graft (meniscus, femur, tibia) 3 Refixation of osteochondral fragment 14 Chondroplasty (AMIC) 4

Open mobilisation (Judet) 4 Soft tissue intervention 44 Haematoma evacuation 14 Diagnostic athroscopy 46 Therapeutic arthroscopy Removal of floating cartilage 74 Plica resection 119 Cartilage shaving 149 Microfracture, Pridie drilling 70 (Partial) meniscectomy 391 Meniscal suture 133 Cruciate ligament suture 3 Cruciate ligament replacement 269 Arthrolysis 6 Synovectomy 51 Irrigation drainage 15 Haematoma evacuation 1 Biopsy 39 Notchplasty 31 Defect filling with autologous cancellous bone 7 Debridement, resection 34 Hoffa’s fat pad excision 16 Removal of osteosynthesis material 12 Patellar reduction 2 Osteosynthesis 1 (Hemi)patellectomy 5 Partial resection, Pridie drilling of the patella 29 Patellar bone graft 1 Patellar mosaicplasty 4 Patellar reconstruction (neopatella) 1 Chondrocyte transplant (ACT I), patella 15 Patellar chondroplasty (AMIC) 9 Cartilage fragmentation and graft, patella 10 Removal of osteosynthesis material 13 Patellar abrasion 6 Refixation of patellar dissecation 2 Intervention on the patellar ligament 104 Bone resection with soft tissue interposition 2 2 995

123

Facts and Figures

Lower leg Individual interventions on 465 patients Reduction 21 Osteotomy 23 Infracondylar osteotomy 26 Osteosynthesis 35 Bone resection, decortication 64 Chondrocyte transplant (ACT I), tibia 1 Decortication 2 Bone graft 88 Bone drainage 3 Bone drilling (Pridie) 5 Epiphysiodesis 85 Removal of osteosynthesis material 217 Tibial tuberosity transposition 49 Soft tissue intervention 80 699 Individual interventions on 1611 patients Ankle / Foot Intervention for hallux valgus / rigidus Scarf 501 Lapidus 29 Akin 501 Plantar plate reconstruction 21 MTP arthrodesis for rigidus 118 Cheilectomy 48 Intervention for toe deformity, metatarsalgia (Hohmann, Weil osteotomy) 118 Osteotomies Hind- and midfoot (Dwyer, Kelly-Keck, corrective osteotomy) 169 For metatarsalgia (Weil, corrective osteotomy) 292 Other osteotomies 10 Arthrodesis Hindfoot (upper and lower ankle, Chopart, triple) 123 Midfoot (Lisfranc, naviculo-cuneiform) 98 Toes 415 Artificial ankle joint Total prosthesis 25 Prosthesis replacement 3 Prosthesis removal 6 Ankle arthroscopy (arthrodesis, debridement, plica resection) 165 Bone graft 59 Chondroplasty 1 Osteosynthesis (fractures etc.) and removal 235

124

Bone resection (forefoot correction using Lelièvre procedure, Haglund) Tendon surgery Achilles tendon (suture, lengthening, debridement, FHL transfer) Gastrocnemius aponeurosis surgery Transfer, lengthening, suture, Girdlestone-Taylor Interventions on nerves Morton, tarsal tunnel Suture, neurolysis, neurotomy Tumour excision Soft tissue intervention (bursectomy, scar revision etc.) Interventions on ligaments Other interventions Amputation, exarticulation

Individual interventions Operations (outpatient and inpatient)

389

78 22 681 252 3 9 127 41 43 3 4 585

20 650 8 976

125

List of Publications

List of Publications

List of Publications Original work (In peer-reviewed journals) 1.

Aradi B, Kato M, Filkova M, Karouzakis E, Klein K, Scharl M, Kolling C, Michel BA, Gay RE, Buzas EI, Gay S and Jüngel A. Protein tyrosine phosphatase nonreceptor type 2: an important regulator of lnterleukin-6 production in rheumatoid arthritis synovial fibroblasts. Arthritis Rheumatol 67: 2624 – 2633, 2015.

2.

Audigé L, Blum R, Müller AM, Flury M and Durchholz H. Complications following arthroscopic rotator cuff tear repair: a systematic review of terms and definitions with focus on shoulder stiffness. Orthop J Sports Med 3: 2325967115587861, 2015.

3.

Bangsbo J, Hansen PR, Dvořák J and Krustrup P. Recreational football for disease prevention and treatment in untrained men: a narrative review examining cardiovascular health, lipid profile, body composition, muscle strength and functional capacity. Br J Sports Med 49: 568 – 576, 2015.

4.

Baume N, Jan N, Emery C, Mandanis B, Schweizer C, Giraud S, Leuenberger N, Marclay F, Nicoli R, Perrenoud L, Robinson N, Dvořák J and Saugy M. Antidoping programme and biological monitoring before and during the 2014 FIFA World Cup Brazil. Br J Sports Med 49: 614 – 622, 2015.

5.

Bellut D, Burkhardt JK, Mannion AF and Porchet F. Assessment of outcome in patients undergoing surgery for intradural spinal tumor using the multidimensional patientrated Core Outcome Measures Index and the modified McCormick Scale. Neurosurg Focus 39: E2, 2015.

6.

7.

8.

9.

Bode G, von Heyden J, Pestka J, Schmal H, Salzmann G, Südkamp N and Niemeyer P. Prospective 5-year survival rate data following open-wedge valgus high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 23: 1949 –1955, 2015. Brunner R, Maffiuletti NA, Casartelli NC, Bizzini M, Sutter R, Pfirrmann CW and Leunig M. Prevalence and functional consequences of femoroacetabular impingement in young male ice hockey players. Am J Sports Med (Epub ahead of print) DOI: 10.1177/0363546515607000, 2015. Burgstaller JM, Porchet F, Steurer J and Wertli MM. Arguments for the choice of surgical treatments in patients with lumbar spinal stenosis – a systematic appraisal of randomized controlled trials. BMC Musculoskelet Disord 16: 96, 2015. Burkhardt JK, Mannion AF, Marbacher S, Kleinstück FS, Jeszenszky D and Porchet F. The influence of cervical plate fixation with either autologous bone or cage insertion on radiographic and patient-rated outcomes after two-level anterior cervical discectomy and fusion. Eur Spine J 24: 113 –119, 2015.

10. Camine VM, Rüdiger H, Pioletti DP and Terrier A. Distribution of gap and micromotion during compressive loading around a cementless femoral stem. Comput Methods Biomech Biomed Engin 18 Suppl 1: 1896 –1897, 2015. 11. Casartelli NC, Bolszak S, Impellizzeri FM and Maffiuletti NA. Reproducibility and validity of the physical activity scale for the elderly (PASE) questionnaire in patients after total hip arthroplasty. Phys Ther 95: 86 – 94, 2015. 12. Casartelli NC, Leunig M, Maffiuletti NA and Bizzini M. Return to sport after hip surgery for femoroacetabular impingement: a systematic review. Br J Sports Med 49: 819 – 824, 2015.

13. Chen C, Kojcev R, Haschtmann D, Fekete TF, Nolte L and Zheng G. Ruler based automatic C-arm image stitching without overlapping constraint. J Digit Imaging 28: 474 – 480, 2015.

27. Fuller CW, Thiele ES, Flores M, Junge A, Netto D and Dvořák J. A successful nationwide implementation of the ’FIFA 11 for Health’ programme in Brazilian elementary schools. Br J Sports Med 49: 623 – 629, 2015.

14. Chomiak J, Hurácek J, Dvořák J, Dungl P, Kubes R, Schwarz O and Munzinger U. Lesion of gluteal nerves and muscles in total hip arthroplasty through 3 surgical approaches. An electromyographically controlled study. Hip Int 25: 176 –183, 2015.

28. Glanzmann MC and Audigé L. Efficacy of platelet-rich plasma injections for chronic medial epicondylitis. J Hand Surg Eur Vol 40: 744 –745, 2015.

15. Dudli S, Boffa DB, Ferguson SJ and Haschtmann D. Leukocytes enhance inflammatory and catabolic degenerative changes in the intervertebral disc after endplate fracture in vitro without infiltrating the disc. Spine (Phila Pa 1976) 40: 1799 –1806, 2015. 16. Dudli S, Haschtmann D and Ferguson SJ. Persistent degenerative changes in the intervertebral disc after burst fracture in an in vitro model mimicking physiological post-traumatic conditions. Eur Spine J 24: 1901 –1908, 2015. 17. Durchholz H, Flury M, Schwyzer HK and Audigé L. Standardisierung von chirurgischen Komplikationen nach arthroskopischer Rotatorenmanschettenrekonstruktion. Obere Extremität 10: 258 – 263, 2015. 18. Edouard P, Feddermann-Demont N, Alonso JM, Branco P and Junge A. Sex differences in injury during top-level international athletics championships: surveillance data from 14 championships between 2007 and 2014. Br J Sports Med 49: 472 – 477, 2015. 19. Elfering A, Müller U, Rolli Salathé C, Tamcan Ö and Mannion AF. Pessimistic back beliefs and lack of exercise: a longitudinal risk study in relation to shoulder, neck, and back pain. Psychol Health Med 20: 767 – 780, 2015. 20. Fanchini M, Ferraresi I, Modena R, Schena F, Coutts AJ and Impellizzeri FM. Use of CR100 scale for session-RPE in soccer and interchangeability with CR10. Int J Sports Physiol Perform (Epub ahead of print) DOI: 10.1123/ijspp. 2015 – 0273, 2015. 21. Fanchini M, Ghielmetti R, Coutts AJ, Schena F and Impellizzeri FM. Effect of training-session intensity distribution on session rating of perceived exertion in soccer players. Int J Sports Physiol Perform 10: 426 – 430, 2015. 22. Fanchini M, Schena F, Castagna C, Petruolo A, Combi F, McCall A and Impellizzeri FM. External responsiveness of the Yo-Yo IR test level 1 in high-level male soccer players. Int J Sports Med 36: 735 – 741, 2015. 23. Fekete T, Woernle C, Mannion AF, Held U, Min K, Kleinstück FS, Ulrich N, Haschtmann D, Becker HJ, Porchet F, Theiler R and Steurer J. The effect of epidural steroid injection on postoperative outcome in patients from the lumbar spinal stenosis outcome study. Spine (Phila Pa 1976) 40: 1303 –1310, 2015. 24. Feucht MJ, Bigdon S, Bode G, Salzmann GM, Dovi-Akue D, Südkamp NP and Niemeyer P. Associated tears of the lateral meniscus in anterior cruciate ligament injuries: risk factors for different tear patterns. J Orthop Surg Res 10: 34, 2015. 25. Frouzakis R, Herren DB and Marks M. Evaluation of expectations and expectation fulfillment in patients treated for trapeziometacarpal osteoarthritis. J Hand Surg Am 40: 483 – 490, 2015. 26. Fuller CW, Junge A, Amaning J, Kaijage R, Kaputa J, Magwende G, Pambo P and Dvořák J. FIFA 11 for health: implementation in five countries in sub-Saharan Africa. Health Educ J 74: 103 –119, 2015.

29. Glanzmann MC and Audigé L. Platelet-rich plasma for chronic lateral epicondylitis: is one injection sufficient ? Arch Orthop Trauma Surg 135: 1637 –1645, 2015. 30. Glück M, Gardner O, Czekanska E, Alini M, Stoddart MJ, Salzmann GM and Schmal H. Induction of osteogenic differentiation in human mesenchymal stem cells by crosstalk with osteoblasts. Biores Open Access 4: 121 –130, 2015. 31. Haas T, Spielmann N, Restin T, Seifert B, Henze G, Obwegeser J, Min K, Jeszenszky D, Weiss M and Schmugge M. Higher fibrinogen concentrations for reduction of transfusion requirements during major paediatric surgery: a prospective randomised controlled trial. Br J Anaesth 115: 234 –243, 2015. 32. Hammes D, Aus der Funten K, Kaiser S, Frisen E, Bizzini M and Meyer T. Injury prevention in male veteran football players – a randomised controlled trial using “FIFA 11+”. J Sports Sci 33: 873 – 881, 2015. 33. Hammes D, Aus der Funten K, Kaiser S, Frisen E, Dvořák J and Meyer T. Injuries of veteran football (soccer) players in Germany. Res Sports Med 23: 215 –226, 2015. 34. Henkelmann R, Schmal H, Pilz IH, Salzmann GM, DoviAkue D and Südkamp NP. Prospective clinical trial of patients who underwent ankle arthroscopy with articular diseases to match clinical and radiological scores with intra-articular cytokines. Int Orthop 39: 1631 –1637, 2015. 35. Hensler S, Herren DB and Marks M. New technical design of food packaging makes the opening process easier for patients with hand disorders. Appl Ergon 50: 1 –7, 2015. 36. Impellizzeri FM, Mannion AF, Naal FD and Leunig M. Validation of the Core Outcome Measures Index in patients with femoroacetabular impingement. Arthroscopy 31: 1238 –1246, 2015. 37. Impellizzeri FM, Mannion AF, Naal FD and Leunig M. Validity, reproducibility, and responsiveness of the Oxford Hip Score in patients undergoing surgery for femoroacetabular impingement. Arthroscopy 31: 42 – 50, 2015. 38. Impellizzeri FM, Naal FD, Mannion AF and Leunig M. Preferred patient-rated outcome measure in patients with femoroacetabular impingement: a comparison between selected instruments. J Hip Preserv Surg (Epub ahead of print) DOI: 10.1093/jhps/hnv057, 2015. 39. Janssen SJ, Teunis T, Guitton TG, Ring D and Science of Variation Group: Durchholz H. Do surgeons treat their patients like they would treat themselves ? Clin Orthop Relat Res 473: 3564 –3572, 2015. 40. Jiménez SR, Benítez A, González MAG, Feliu GM and Maffiuletti NA. Effect of vibration frequency on agonist and antagonist arm muscle activity. Eur J Appl Physiol 115: 1305 –1312, 2015. 41. Junge A and Dvořák J. Football injuries during the 2014 FIFA World Cup. Br J Sports Med 49: 599 – 602, 2015. 42. Kramer EB, Serratosa L, Drezner J and Dvořák J. Sudden cardiac arrest on the football field of play – highlights for sports medicine from the European Resuscitation Council 2015 consensus guidelines. Br J Sports Med (Epub ahead of print) DOI: 10.1136/bjsports-2015-095706, 2015.

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43. Kurmann A, Fischer H, Dell-Kuster S, Rosenthal R, Audigé L, Schupfer G, Metzger J and Honigmann P. Effect of intraoperative infiltration with local anesthesia on the development of chronic pain after inguinal hernia repair: a randomized, triple-blinded, placebo-controlled trial. Surgery 157: 144 –154, 2015.

List of Publications

44. Langenmair ER, Kubosch EJ, Salzmann GM, Beck S and Schmal H. Clinical trial and in vitro study for the role of cartilage and synovia in acute articular infection. Mediators Inflamm 2015: 1– 9, 2015. 45. Lattig F, Fekete TF, Kleinstück FS, Porchet F, Jeszenszky D and Mannion AF. Lumbar facet joint effusion on MRI as a sign of unstable degenerative spondylolisthesis: should it influence the treatment decision ? J Spinal Disord Tech 28: 95 –100, 2015. 46. Lienhard K, Vienneau J, Friesenbichler B, Nigg S, Meste O, Nigg BM and Colson SS. The effect of whole-body vibration on muscle activity in active and inactive subjects. Int J Sports Med 36: 585 – 591, 2015. 47. Loebel C, Czekanska EM, Bruderer M, Salzmann G, Alini M and Stoddart MJ. In vitro osteogenic potential of human mesenchymal stem cells is predicted by Runx2 /Sox9 ratio. Tissue Eng Part A 21: 115 –123, 2015. 48. Mannion AF, Fekete TF, Wertli MM, Mattle M, Nauer S, Kleinstück FS, Jeszenszky D, Haschtmann D, Becker HJ and Porchet F. Could less be more when assessing patient-rated outcome in spinal stenosis ? Spine (Phila Pa 1976) 40: 710 –718, 2015. 49. Mannion AF, Impellizzeri FM, Naal FD and Leunig M. Women demonstrate more pain and worse function before THA but comparable results 12 months after surgery. Clin Orthop Relat Res 473: 3849 – 3857, 2015. 50. Mannion AF, Vila-Casademunt A, Domingo-Sàbat M, Wunderlin S, Pellisé F, Bago J, Acaroglu E, Alanay A, Pérez-Grueso FS, Obeid I, Kleinstück FS and the European Spine Study Group (ESSG). The Core Outcome Measures Index (COMI) is a responsive instrument for assessing the outcome of treatment for adult spinal deformity. Eur Spine J (Epub ahead of print) DOI: 10.1007/s00586-015-4292-4, 2015. 51. Marbacher S, Mannion AF, Burkhardt JK, Schar RT, Porchet F, Kleinstück FS, Jeszenszky D, Fekete TF and Haschtmann D. Patient-rated outcomes of lumbar fusion in patients with degenerative disease of the lumbar spine: does age matter ? Spine (Phila Pa 1976) (Epub ahead of print) DOI: 10.1097/BRS.0000000000001364, 2015. 52. Marks M, Audigé L, Reissner L, Herren DB, Schindele S and Vliet Vlieland TP. Determinants of patient satisfaction after surgery or corticosteroid injection for trapeziometacarpal osteoarthritis: results of a prospective cohort study. Arch Orthop Trauma Surg 135: 141 – 147, 2015. 53. Marks M, Vliet Vlieland TP, Audigé L, Herren DB, Nelissen RG and van den Hout WB. Healthcare costs and loss of productivity in patients with trapeziometacarpal osteoarthritis. J Hand Surg Eur Vol 40: 927– 934, 2015. 54. McCall A, Carling C, Davison M, Nedelec M, Le Gall F, Berthoin S and Dupont G. Injury risk factors, screening tests and preventative strategies: a systematic review of the evidence that underpins the perceptions and practices of 44  football (soccer) teams from various premier leagues. Br J Sports Med 49: 583 – 589, 2015. 55. McCall A, Davison M, Andersen TE, Beasley I, Bizzini M, Dupont G, Duffield R, Carling C and Dvořák J. Injury prevention strategies at the FIFA 2014 World Cup: perceptions and practices of the physicians from the 32 participating national teams. Br J Sports Med 49: 603 – 608, 2015.

128

56. Medeiros FV, Vieira A, Carregaro RL, Bottaro M, Maffiuletti NA and Durigan JL. Skinfold thickness affects the isometric knee extension torque evoked by neuromuscular electrical stimulation. Braz J Phys Ther 19: 466 – 472, 2015. 57. Minetto MA, Caresio C, Menapace T, Hajdarevic A, Marchini A, Molinari F and Maffiuletti NA. Ultrasound-based detection of low muscle mass for diagnosis of sarcopenia in older adults. PM R (Epub ahead of print) DOI: 10.1016/j. pmrj.2015.09.014, 2015. 58. Miozzari HH, Celia M, Clark JM, Werlen S, Naal FD and Nötzli HP. No regeneration of the human acetabular labrum after excision to bone. Clin Orthop Relat Res 473: 1349 –1357, 2015. 59. Morf C, Wellauer V, Casartelli NC and Maffiuletti NA. Acute effects of multipath electrical stimulation in patients with total knee arthroplasty. Arch Phys Med Rehabil 96: 498 – 504, 2015. 60. Mountjoy M, Junge A, Benjamen S, Boyd K, Diop M, Gerrard D, van den Hoogenband CR, Marks S, Martinez-Ruiz E, Miller J, Nanousis K, Shahpar FM, Veloso J, van Mechelen W and Verhagen E. Competing with injuries: injuries prior to and during the 15th FINA World Championships 2013 (aquatics). Br J Sports Med 49: 37– 43, 2015. 61. Naal FD, Dalla Riva F, Würz TH, Dubs B and Leunig M. Sonographic prevalence of groin hernias and adductor tendinopathy in patients with femoroacetabular impingement. Am J Sports Med 43: 2146 – 2151, 2015. 62. Naal FD, Impellizzeri FM, Lenze U, Wellauer V, von Eisenhart-Rothe R and Leunig M. Clinical improvement and satisfaction after total joint replacement: a prospective 12-month evaluation on the patients’ perspective. Qual Life Res 24: 2917 – 2925, 2015. 63. Naal FD, Impellizzeri FM, Torka S, Wellauer V, Leunig M and von Eisenhart-Rothe R. The German Lower Extremity Functional Scale (LEFS) is reliable, valid and responsive in patients undergoing hip or knee replacement. Qual Life Res 24: 405 – 410, 2015. 64. Nassis GP, Brito J, Dvořák J, Chalabi H and Racinais S. The association of environmental heat stress with performance: analysis of the 2014 FIFA World Cup Brazil. Br J Sports Med 49: 609 – 613, 2015. 65. Neyroud D, Temesi J, Millet GY, Verges S, Maffiuletti NA, Kayser B and Place N. Comparison of electrical nerve stimulation, electrical muscle stimulation and magnetic nerve stimulation to assess the neuromuscular function of the plantar flexor muscles. Eur J Appl Physiol 115: 1429 – 1439, 2015. 66. Ochi K, Schindele S and Herren D. Zone 2 rupture of finger flexor tendons due to sharp bone spikes at volarly dislocated metacarpophalangeal joints in patients with rheumatoid arthritis. J Hand Surg Eur Vol (Epub ahead of print) DOI: 10.1177/1753193414567426, 2015. 67. Omair A, Mannion AF, Holden M, Fairbank J, Lie BA, Hagg O, Fritzell P and Brox JI. Catechol-O-methyltransferase (COMT) gene polymorphisms are associated with baseline disability but not long-term treatment outcome in patients with chronic low back pain. Eur Spine J 24: 2425 –2431, 2015. 68. Omair A, Mannion AF, Holden M, Leivseth G, Fairbank J, Hagg O, Fritzell P and Brox JI. Age and pro-inflammatory gene polymorphisms influence adjacent segment disc degeneration more than fusion does in patients treated for chronic low back pain. Eur Spine J (Epub ahead of print) DOI: 10.1007/s00586-015-4181-x, 2015.

69. Pawson DJ, Glanzmann MC, Luechinger R, Müller R and Stok KS. Quantitative morphometric patterns in cartilage and bone from the humeral heads of end-stage osteoarthritis patients. Osteoarthritis Cartilage 23: 1377 –1387, 2015. 70. Pedrinelli A, Ejnisman L, Fagotti L, Dvořák J and Tscholl PM. Medications and nutritional supplements in athletes during the 2000, 2004, 2008, and 2012 FIFA Futsal World Cups. Biomed Res Int 2015: 870308, 2015. 71. Pellisé F, Vila-Casademunt A, Ferrer M, Domingo-Sabat M, Bago J, Perez-Grueso FJ, Alanay A, Mannion AF, Acaroglu E and the European Spine Study Group (ESSG). Impact on health related quality of life of adult spinal deformity (ASD) compared with other chronic conditions. Eur Spine J 24: 3 –11, 2015. 72. Pochon L, Kleinstück FS, Porchet F and Mannion AF. Influence of gender on patient-oriented outcomes in spine surgery. Eur Spine J (Epub ahead of print) DOI: 10.1007/ s00586-015-4062-3, 2015. 73. Reissner L, Marks M, Schindele S and Herren DB. Comparison of clinical outcome with radiological findings after trapeziectomy with ligament reconstruction and tendon interposition. J Hand Surg Eur Vol (Epub ahead of print) DOI: 10.1177/1753193415616959, 2015. 74. Rössler R, Donath L, Bizzini M and Faude O. A new injury prevention programme for children’s football – FIFA 11+ Kids – can improve motor performance: a cluster-randomised controlled trial. J Sports Sci (Epub ahead of print) DOI: 10.1080/02640414.2015.1099715, 2015. 75. Rössler R, Junge A, Chomiak J, Dvořák J and Faude O. Soccer injuries in players aged 7 to 12 years: a descriptive epidemiological study over 2 seasons. Am J Sports Med (Epub ahead of print) DOI: 10.1177/0363546515614816, 2015. 76. Rüdiger HA, Parvex V and Terrier A. Impact of the femoral head position on moment arms in total hip arthroplasty: a parametric finite element study. J Arthroplasty (Epub ahead of print) DOI: 10.1016/j.arth.2015.09.044, 2015. 77. Saier T, Cotic M, Kirchhoff C, Feucht MJ, Minzlaff P, Glanzmann MC, Schottle P and Imhoff AB. Early results after modular non-cemented reverse total shoulder arthroplasty: a prospective single-centre study of 38 consecutive cases. J Orthop Sci 20: 830 – 836, 2015. 78. Salzmann GM, Preiss S, Harder LP and Naal FD. Inside-out trans-arthroscopic drain application during knee joint arthroscopy. Arthrosc Tech (Epub ahead of print) DOI: 10.1016/ j.eats.2015.07.003, 2015. 79. Scharhag J, Bohm P, Dvořák J and Meyer T. F-MARC: the FIFA Sudden Death Registry (FIFA-SDR). Br J Sports Med 49: 563 – 565, 2015. 80. Schindele S, Hensler S, Audigé L, Marks M and Herren DB. A modular surface gliding implant (CapFlex-PIP) for proximal interphalangeal joint osteoarthritis: a prospective case series. J Hand Surg Am 40: 334 –340, 2015. 81. Schmidt S, Vieth V, Timme M, Dvořák J and Schmeling A. Examination of ossification of the distal radial epiphysis using magnetic resonance imaging. New insights for age estimation in young footballers in FIFA tournaments. Sci Justice 55: 139 –144, 2015. 82. Schneider K, Oh JK, Zderic I, Stoffel K, Richards RG, Wolf S, Gueorguiev B and Nork SE. What is the underlying mechanism for the failure mode observed in the proximal femoral locking compression plate ? A biomechanical study. Injury 46: 1483 –1490, 2015.

83. Seif Barghi T, Halabchi F, Dvořák J and Hosseinnejad H. How the Iranian football coaches and players know about doping ? Asian J Sports Med 6: e24392, 2015. 84. Setuain I, Millor N, Gonzalez-Izal M, Gorostiaga EM, Gomez M, Alfaro-Adrian J, Maffiuletti NA and Izquierdo M. Biomechanical jumping differences among elite female handball players with and without previous anterior cruciate ligament reconstruction: a novel inertial sensor unit study. Sports Biomech 14: 323 – 339, 2015. 85. Silvers-Granelli H, Mandelbaum B, Adeniji O, Insler S, Bizzini M, Pohlig R, Junge A, Snyder-Mackler L and Dvořák J. Efficacy of the FIFA 11+ injury prevention program in the collegiate male soccer player. Am J Sports Med 43: 2628 – 2637, 2015. 86. Sobottke R, Herren C, Siewe J, Mannion AF, Röder C and Aghayev E. Predictors of improvement in quality of life and pain relief in lumbar spinal stenosis relative to patient age: a study based on the Spine Tango registry. Eur Spine J (Epub ahead of print) DOI: 10.1007/s00586-015-4078-8, 2015. 87. Staub LP, Ryser C, Röder C, Mannion AF, Jarvik JG, Aebi M and Aghayev E. Total disc arthroplasty versus anterior cervical interbody fusion: use of the Spine Tango registry to supplement the evidence from RCTs. Spine J (Epub ahead of print) DOI: 10.1016/j.spinee.2015.11.056, 2015. 88. Taha ME, Audigé L, Siegel G and Renner N. Factors predicting secondary displacement after non-operative treatment of undisplaced femoral neck fractures. Arch Orthop Trauma Surg 135: 243 –249, 2015. 89. Tscholl PM, Junge A, Dvořák J and Zubler V. MRI of the wrist is not recommended for age determination in female football players of U-16 / U-17 competitions. Scand J Med Sci Sports (Epub ahead of print) DOI: 10.1111/sms.12461, 2015. 90. Tscholl PM, Vaso M, Weber A and Dvořák J. High prevalence of medication use in professional football tournaments including the World Cups between 2002 and 2014: a narrative review with a focus on NSAIDs. Br J Sports Med 49: 580 – 582, 2015. 91. Ulrich NH, Kleinstück F, Woernle CM, Antoniadis A, Winklhofer S, Burgstaller JM, Farshad M, Oberle J, Porchet F and Min K. Clinical outcome in lumbar decompression surgery for spinal canal stenosis in the aged population: a prospective Swiss multicenter cohort study. Spine (Phila Pa 1976) 40: 415 – 422, 2015.

96. Wellauer V, Morf C, Minetto MA, Place N and Maffiuletti NA. Assessment of quadriceps muscle inactivation with a new electrical stimulation paradigm. Muscle Nerve 51: 117 –124, 2015. 97. Witte L, Schneider MM, Jung C and Flury M. Medial rotator cuff failure. Arthroskopie 28: 237 – 238, 2015.

Reviews and other articles 1.

Aepli M, Ganz R, Manner HM and Leunig M. Development of bilateral cam deformity after Dunn procedure and contralateral prophylactic fixation: a periosteal reaction ? JBJS Case Connect 5: e53, 2015.

2.

Ahmed OH, Hussain AW, Beasley I, Dvořák J and Weiler R. Enhancing performance and sport injury prevention in disability sport: moving forwards in the field of football. Br J Sports Med 49: 566 – 567, 2015.

3.

Ardern CL, Bizzini M and Bahr R. It is time for consensus on return to play after injury: five key questions. Br J Sports Med (Epub ahead of print) DOI: 10.1136/bjsports-2015095475, 2015.

4.

Bizzini M and Dvořák J. FIFA 11+: an effective programme to prevent football injuries in various player groups worldwide – a narrative review. Br J Sports Med 49: 577 – 579, 2015.

5.

Casartelli NC, Bizzini M, Maffiuletti NA, Lepers R and Leunig M. Rehabilitation and return to sport after bilateral open surgery for femoroacetabular impingement in a professional ice hockey player: a case report. Phys Ther Sport 16: 193 – 201, 2015.

6.

Casartelli NC, Maffiuletti NA, Leunig M and Bizzini M. Femoroacetabular impingement in sports medicine: a narrative review. Schweizerische Zeitschrift für Sportmedizin und Sporttraumatologie 63: 13 –17, 2015.

7.

8.

Drobny L, Preiss S, Harder L and von Knoch F. Mediale Gonarthrose mit juxtaartikulärer tibialer Varusdeformität: Kombinierte unikondyläre Kniearthroplastik und aufklappende hohe Tibiaosteotomie. Video report. Orthopäde 44: 595 – 598, 2015. Dvořák J and Junge A. Twenty years of the FIFA Medical Assessment and Research Centre: from ’medicine for football’ to ’football for health’. Br J Sports Med 49: 561 – 563, 2015.

92. Vaso M, Weber A, Tscholl PM, Junge A and Dvořák J. Use and abuse of medication during 2014 FIFA World Cup Brazil: a retrospective survey. BMJ Open 5: e007608, 2015.

9.

93. Veldman MP, Zijdewind I, Solnik S, Maffiuletti NA, Berghuis KM, Javet M, Negyesi J and Hortobagyi T. Direct and crossed effects of somatosensory electrical stimulation on motor learning and neuronal plasticity in humans. Eur J Appl Physiol 115: 2505 –2519, 2015.

10. Feucht MJ, Salzmann GM, Bode G, Pestka JM, Kuhle J, Südkamp NP and Niemeyer P. Posterior root tears of the lateral meniscus. Knee Surg Sports Traumatol Arthrosc 23: 119 –125, 2015.

94. Wegrzyk J, Fouré A, Le Fur Y, Maffiuletti NA, Vilmen C, Guye M, Mattei JP, Place N, Bendahan D and Gondin J. Responders to wide-pulse, high-frequency neuromuscular electrical stimulation show reduced metabolic demand: a 31P-MRS study in humans. PLoS One 10: e0143972, 2015. 95. Wegrzyk J, Fouré A, Vilmen C, Ghattas B, Maffiuletti NA, Mattei JP, Place N, Bendahan D and Gondin J. Extra forces induced by wide-pulse, high-frequency electrical stimulation: occurrence, magnitude, variability and underlying mechanisms. Clin Neurophysiol 126: 1400 –1412, 2015.

Edwards KL, Schizas C, Mannion AF, Aebi M and Gunzburg R. How to be a good reviewer. Eur Spine J 24: 1 – 2, 2015.

11. Friesenbichler B, Lepers R and Maffiuletti NA. Soleus and lateral gastrocnemius H-reflexes during standing with unstable footwear. Muscle Nerve 51: 764 –766, 2015. 12. Gkagkalis G, Mettraux P, Omoumi P, Mischler S and Rüdiger HA. Adverse tissue reaction to corrosion at the neckstem junction after modular primary total hip arthroplasty. Orthop Traumatol Surg Res 101: 123 –126, 2015.

15. Herren D. Commentary on Singh et al. Nonunion after trapeziometacarpal arthrodesis: comparison between K-wire and internal fixation and Smeraglia et al. Trapeziometacarpal arthrodesis: is bone union necessary for a good outcome ? J Hand Surg Eur Vol 40: 362– 363, 2015. 16. Herzig D, Maffiuletti NA and Eser P. The application of neuromuscular electrical stimulation training in various nonneurologic patient populations: a narrative review. PM R 7: 1167 –1178, 2015. 17. Kamath AF, Ganz R, Zhang H, Grappiolo G and Leunig M. Subtrochanteric osteotomy for femoral maltorsion through a surgical dislocation approach. Journal of Hip Preservation Surgery 2: 65 –79, 2015. 18. Kramer EB, Dvořák J, Schmied C and Meyer T. F-MARC: promoting the prevention and management of sudden cardiac arrest in football. Br J Sports Med 49: 597 – 598, 2015. 19. Leunig M and Ganz R. Editorial comment: 2014 International Hip Society proceedings. Clin Orthop Relat Res 473: 3714 – 3715, 2015. 20. Leunig M and Maffiuletti NA. CORR insights®: patientspecific anatomical and functional parameters provide new insights into the pathomechanism of cam FAI. Clin Orthop Relat Res 473: 1297 –1298, 2015. 21. Mannion AF, Brox JI and Fairbank JC. Reply to letter to the editor from Berg S, Tullberg T. Letter to the editor regarding Mannion, Brox, Fairbank. Comparison of spinal fusion and nonoperative treatment in patients with chronic low back pain: long-term follow-up of three randomized controlled trials. Spine J 2014;14:1087. Spine J 15: 380 – 381, 2015. 22. Meyer T and Impellizzeri FM. Is it all about load ? J Sports Sci 33: 2079, 2015. 23. Mithöfer K, Peterson L, Zenobi-Wong M and Mandelbaum BR. Cartilage issues in football – today’s problems and tomorrow’s solutions. Br J Sports Med 49: 590 – 596, 2015. 24. Mountjoy M, Junge A, Alonso JM, Clarsen B, Pluim BM, Shrier I, van den Hoogenband C, Marks S, Gerrard D, Heyns P, Kaneoka K, Dijkstra HP and Khan KM. Consensus statement on the methodology of injury and illness surveillance in FINA (aquatic sports). Br J Sports Med (Epub ahead of print) DOI: 10.1136/bjsports-2015-095686, 2015. 25. Niemeyer P, Uhl M, Salzmann GM, Morscheid YP, Südkamp NP and Madry H. Evaluation and analysis of graft hypertrophy by means of arthroscopy, biochemical MRI and osteochondral biopsies in a patient following autologous chondrocyte implantation for treatment of a  fullthickness-cartilage defect of the knee. Arch Orthop Trauma Surg 135: 819 – 830, 2015. 26. Schneider MM, Preiss S, Harder LP and Salzmann GM. Destructive chondrolysis following intraarticular application of lavasorb (polihexanid) for treatment of knee empyema. MMW Fortschr Med 157: 47– 48, 2015. 27. Schomacher J and Bizzini M. Risikofaktoren für Koxarthrose und ihre physiotherapeutische Behandlung. Teil 1 – Instabilität des Hüftgelenkes. PT Zeitschrift für Physiotherapeuten 67: 23 – 31, 2015.

13. Glanzmann MC. Charakteristik der ventralen Schulterinstabilität. Arthroskopie 28: 274 –280, 2015.

28. Schomacher J and Bizzini M. Risikofaktoren für Koxarthrose und ihre physiotherapeutische Behandlung. Teil 2 – Femoroacetabuläres Impingement (FAI). PT Zeitschrift für Physiotherapeuten 67: 28 – 35, 2015.

14. Hackl M, Moro F and Durchholz H. Combined displaced fracture of the lesser humeral tuberosity and the scapular spine: a case report. Int J Surg Case Rep 13: 106 –111, 2015.

29. Weber KP, Schweier C, Kana V, Guggi T, Byber K and Landau K. Wear and tear vision. J Neuroophthalmol 35: 82– 85, 2015.

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List of Publications

Books 1.

Kluge S. Ultraschalldiagnostik der Hand: Heidelberg, Germany: Springer-Verlag, 2015.

2.

Meyer R, Moro F, Schwyzer HK, Simmen B and Flury M. Extremitätenchirurgie im Wandel: Heidelberg, Germany: Springer-Verlag, 2015.

3.

Nho SJ, Leunig M, Larson CM, Bedi A and Kelly BT. Hip Arthroscopy and Hip Joint Preservation Surgery: New York, USA: Springer, 2015.

Book contributions

12. Junge A. Epidemiology in Female Football Players. In: Football Traumatology: New Trends (2nd ed.), edited by Volpi P. Cham, Switzerland: Springer International Publishing, 2015, p. 21–27. 13. Latham W, Hausmann C and Lau J. The Hintegra Prosthesis: Design and Implementation Pitfalls Resulting in Revision Surgery. In: Total Ankle Arthroplasty, edited by Haddad SL. Rosemont, USA: American Academy of Orthopaedic Surgeons, 2015, p. 135 –142. 14. Leunig M, Azegami S, Kamath AF and Ganz R. Femoro-Acetabular Impingement: Definition, Etiology, Pathophysiology. In: Hip Arthroscopy and Hip Joint Preservation Surgery, edited by Nho SJ, Leunig M, Larson CM, Bedi A and Kelly BT. New York, USA: Springer, 2015, p. 681– 688.

Achermann Y and Glanzmann MC. Periprosthetic Joint Infection after Elbow Arthroplasty. In: Bone and Joint Infections: From Microbiology to Diagnostics and Treatment, edited by Zimmerli W. Chichester, UK: John Wiley & Sons, Ltd, 2015, p. 167–182.

2.

Aepli M, Kamath AF, Ganz R and Leunig M. Coxa Profunda e Protrusão Acetabular. In: Cirurgia Preservadora do Quadril Adulto, edited by Gomes LSM. São Paulo, Brazil: Editora Atheneu, 2015, p. 507–518.

16. Leunig M and Ganz R. Acetabular Protrusion and Surgical Technique. In: Hip Arthroscopy and Hip Joint Preservation Surgery, edited by Nho SJ, Leunig M, Larson CM, Bedi A and Kelly BT. New York, USA: Springer, 2015, p. 653 – 658.

3.

Beck M, Büchler L, Ganz R and Leunig M. Anatomy of the Proximal Femur. In: The Adult Hip: Hip Preservation Surgery, edited by Clohisy JC, Beaulé PE, DellaValle CJ, Callaghan JJ, Rosenberg AG and Rubash HE. Philadelphia, USA: Wolters Kluwer, 2015, p. 55 – 62.

17. Leunig M and Ganz R. Cirurgia Preservadora do Quadril: Passado, Presente e Futuro. In: Cirurgia Preservadora do Quadril Adulto, edited by Gomes LSM. São Paulo, Brazil: Editora Atheneu, 2015, p. 3 – 32.

Bizzini M and Dvořák J. Football Injury Prevention. In: Football Traumatology: New Trends, edited by Volpi P. Cham, Switzerland: Springer International Publishing, 2015, p. 35 – 46.

18. Leunig M and Ganz R. Hip Dysplasia Overview. In: The Adult Hip: Hip Preservation Surgery, edited by Clohisy JC, Beaulé PE, DellaValle CJ, Callaghan JJ, Rosenberg AG and Rubash HE. Philadelphia, USA: Wolters Kluwer, 2015, p. 195 –204.

5.

Bizzini M, Junge A and Dvořák J. FIFA 11+ Injury Prevention in Amateur Football from Development to Worldwide Dissemination. In: Sports Injuries and Prevention, edited by Kanouse K, Ogawa T, Fukano M and Fukubayashi T. Berlin, Germany: Springer, 2015, p. 199 –208.

6.

Corten K, Carpentier K and Leunig M. Surgical Technique: Open Hip HS Allograft. In: Hip Arthroscopy and Hip Joint Preservation Surgery, edited by Nho SJ, Leunig M, Larson CM, Bedi A and Kelly BT. New York, USA: Springer, 2015, p. 1173 –1179.

7.

Durchholz H. Die Ausbildung in der Medizin – ein «Holund Bringservice». In: Extremitäten im Wandel, edited by Meyer R, Moro F, Schwyzer HK, Simmen B and Flury M. Heidelberg, Germany: Springer-Verlag, 2015, p. 11 –14.

8.

Freeman CR, Leunig M, Beck M and Ganz R. Anatomy of the Acetabulum. In: Fractures of the Pelvis and Acetabulum: Principles and Methods of Management (4th ed.), edited by Tile M, Helfet DL, Kellam JF and Vrahas M. Stuttgart, Germany: Thieme Verlag, 2015, p. 427– 440.

9.

Glanzmann MC. Verfügbarkeit: Schlüssel zum Erfolg und Dilemma unserer Zeit zugleich. In: Extremitäten im Wandel, edited by Meyer R, Moro F, Schwyzer HK, Simmen B and Flury M. Heidelberg, Germany: Springer-Verlag, 2015, p. 27– 28.

10. Jung C. Rehabilitation nach Rotatorenmanschettenrekonstruktion. In: Die Sportlerschulter: Diagnostik, Behandlungsmanagement, Rehabilitation, edited by Grimm C and Engelhardt M. Stuttgart, Germany: Schattauer Verlag, 2015, p. 280. 11. Jung C. Rehabilitation nach Schulterstabilisierung. In: Die Sportlerschulter: Diagnostik, Behandlungsmanagement, Rehabilitation, edited by Grimm C and Engelhardt M. Stuttgart, Germany: Schattauer Verlag, 2015, p. 289.

130

Audigé L, Flury M, Schwyzer HK, Müller AM and Durchholz H. Search for standard for the documentation and evaluation of surgical complications after shoulder arthroplasty. 4th International Congress of Arthroplasty Registries, Gothenburg, Sweden, 23 –25/05/2015.

4.

Audigé L, Flury M, Schwyzer HK, Müller AM and Durchholz H. Suche nach einem internationalen Standard für die Erfassung und Evaluation von chirurgischen Komplikationen nach arthroskopischer Rotatorenmanschettenrekonstruktion und Schulterarthroplastik. 22. Jahreskongress der Deutschen Vereinigung für Schulter- und Ellenbogenchirurgie (DVSE), Mannheim, Germany, 25–27/06/2015.

5.

Audigé L, Müller AM, Flury M, Schwyzer HK, Blum R, Jacxsens M, Walz T and Durchholz H. Search for a standard for the documentation and evaluation of surgical complications after shoulder arthroplasty and arthroscopic rotator cuff tear reconstruction. 75. Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 24 – 26/06/2015. Swiss Med Wkly 145 (Suppl 210) 74S.

6.

Berlemann U, Kleinstück FS, Porchet F, Mannion AF, Röder C, Munting E, Pigott T and Aghayev E. Lumbar spinal stenosis: are decompression alone, decompression with instrumented fusion, or posterior dynamic stabilization treating the same patient ? 42nd Annual Meeting of the  International Society for the Study of the Lumbar Spine (ISSLS), San Francisco, USA, 08 –12/06/2015.

7.

Bizzini M, Junge A and Dvořák J. Dissemination and implementation of FIFA 11+. Sports Medicine Congress, Copenhagen, Denmark, 22 – 24/01/2015.

8.

Bizzini M, Junge A and Dvořák J. Evidence of injury prevention in the female and male athlete. Sports Medicine Congress, Copenhagen, Denmark, 22 – 24/01/2015.

9.

Bizzini M, Junge A and Dvořák J. Football injuries: contact vs. non-contact. Injury prevention programmes. 8th World Congress on Science & Football, Copenhagen, Denmark, 20 – 23/05/2015.

15. Leunig M, Freeman CR, Ganz R and Beck M. Anatomy of Acetabulum. In: The Adult Hip: Hip Preservation Surgery, edited by Clohisy JC, Beaulé PE, DellaValle CJ, Callaghan JJ, Rosenberg AG and Rubash HE. Philadelphia, USA: Wolters Kluwer, 2015, p. 42– 54.

1.

4.

3.

19. Salzmann G. New ACI Generations. In: CartilagE-Book, edited by Berruto M. Rome, Italy: CIC Edizioni Internationali Srl, 2015, p. 156 –166. 20. Schindele S. War früher eine fachspezifische Weiterbildung ohne arbeitsplatzbasierte Assessments zum orthopädischen Chirurgen möglich ? In: Extremitäten im Wandel, edited by Meyer R, Moro F, Schwyzer HK, Simmen B and Flury M. Heidelberg, Germany: Springer-Verlag, 2015, p. 107–110. 21. Tibor LM, Steinwachs MR and Leunig M. Condrogênese Induzida por Matriz Autóloga. In: Cirurgia Preservadora do Quadril Adulto, edited by Gomes LSM. São Paulo, Brazil: Editora Atheneu, 2015, p. 827– 833.

Peer-reviewed congress abstracts 1.

Adravanti P, Guggi T, D’Anchise R, Dwyer K, Lesko J and Kape J. Two year survivorship of unicompartmental knee replacement. International Society for Technology in Arthroplasty (ISTA) Vienna, Austria, 30/09 – 03/10/2015.

2.

Audigé L and Durchholz H. Chirurgische Komplikationen nach arthroskopischer Rotatorenmanschettenrekonstruktion – Standardisierung die Terminologie und Definitionen. 30. Jahreskongress der Gesellschaft für OrthopädischTraumatologische Sportmedizin (GOTS), Basel, Switzerland, 12 –13/06/2015.

10. Bizzini M, Junge A and Dvořák J. Injury prevention programmes in football: an update. XXIV International Conference of Sport Rehabilitation and Traumatology. Football Medicine Strategies for Player Care, London, UK, 11 – 12/04/2015. 11. Brunner R, Casartelli NC, Maffiuletti NA, Bizzini M, Sutter R, Pfirrmann CW and Leunig M. Prevalence and functional consequences of femoroacetabular impingement: exploratory cross-sectional study in male youth ice hockey players. Return to Play – First World Congress in Sports Physical Therapy, Bern, Switzerland, 20 –21/11/2015. 12. Brunner R, Casartelli NC, Maffiuletti NA, Bizzini M, Sutter R, Pfirrmann CW and Leunig M. Prevalence and functional consequences of femoroacetabular impingement: exploratory cross-sectional study in male youth ice hockey players. 75. Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 25 –26/06/2015. Swiss Med Wkly 145 (Suppl 210) 5S. 13. Bruppacher H and Brodmann-Mäder M. A framework describing factors affecting health care providers’ performance in patient resuscitation under the circumstances of limited personnel resources and family member presence. Annual Congress of the European Society of Anaesthesiology, Berlin, Germany, 30/05 – 02/06/2015. 14. Casartelli NC, Leunig M, Maffiuletti NA and Bizzini M. Return to sport after hip surgery for femoroacetabular impingement. 75. Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 24 – 26/06/2015. Swiss Med Wkly 145 (Suppl 210) 6S.

15. Chomiak J, Faude O, Rössler R, Nemec K and Junge A. Severe injuries in children football players. An epidemiological study. 17th Annual Congress of the European Federation of National Associations of Orthopaedics and Traumatology (EFORT), Geneva, Switzerland, 01 – 03/06/2015. 16. Creaco S, Mannion AF, Jeszenszky D, Kleinstück FS, Haschtmann D and Fekete TF. Spinal fusion terminating at L5 in adult scoliosis: factors associated with subsequent extension of the fusion to the sacrum. Eurospine, the Spine Society of Europe, Copenhagen, Denmark, 02– 04/09/2015. 17. Dietrich E. Resektions-Interpositionsarthroplastik des Daumensattelgelenkes: Braucht es eine Thermoplastschiene ? 49. Jahreskongress der Schweizerischen Gesellschaft für Handchirurgie (SGH) /17. Jahreskongress der Schweizerischen Gesellschaft für Handrehabilitation (SGHR), Fribourg, Switzerland, 05 – 06/11/2015. 18. Elfering A, Müller U, Rolli C, Tamcan O and Mannion AF. Pessimistic back beliefs and lack of exercise: a risky combination for future shoulder, neck, and back pain. 42nd Annual Meeting of the International Society for the Study of the Lumbar Spine (ISSLS), San Francisco, USA, 08 – 12/06/2015. 19. Item-Glatthorn JF, Casartelli NC, Salzmann GM and Maffiuletti NA. Knee extensor muscle weakness after knee surgery: type of surgery and contributing factors. 75. Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 24 – 26/06/2015. Swiss Med Wkly 145 (Suppl 210) 54S. 20. Faude O, Feddermann-Demont N, Rössler R, Chomiak J, Junge A and Dvořák J. Kopfverletzungen im Kinderfussball – Ergebnisse einer prospektiven Kohortenstudie. 46. Deutsche Sportärztekongress, Frankfurt, Germany, 11 – 12/09/2015. 21. Fekete TF, Kleinstück FS, Porchet F, Haschtmann D, Jeszenszky D and Mannion AF. What do patients consider to be an acceptable level of pain to live with after surgery for lumbar degenerative disorders ? 42nd Annual Meeting of the International Society for the Study of the Lumbar Spine (ISSLS), San Francisco, USA, 08 –12/06/2015. 22. Fekete TF, Mannion AF, Porchet F, Marbacher S, Kleinstück FS, Jeszenszky D and Burkhardt JK. Two-level anterior cervical discectomy with fusion: does anterior cervical plate fixation influence radiographic and patient-rated outcomes ? 75. Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 24 – 26/06/2015. Swiss Med Wkly 145 (Suppl 210) 13S. 23. Fekete TF, Woernle C, Mannion AF, Held U, Kleinstück FS, Ulrich N, Haschtmann D, Becker HJ, Porchet F, Theiler R, Steurer J and Lumbar Stenosis Outcome Study (LSOS) Group. The effect of epidural steroid injection on postoperative outcome in patients from the Lumbar Spinal Stenosis Outcome Study. Eurospine, the Spine Society of Europe, Copenhagen, Denmark, 02 – 04/09/2015. 24. Flury M, Schwyzer HK, Mauch F, Böhm D, Habermeyer P, Lichtenberg S, Gohlke F, Rolf O, Lehmann L and Schneider T. Ergebnisse der schaftfreien Implantate bei Omarthrose. 22. Jahreskongress der Deutschen Vereinigung für Schulterund Ellenbogenchirurgie (DVSE), Mannheim, Germany, 25 – 27/06/2015. 25. Frank Bertoncelj M, Trenkmann M, Armaka M, Russo G, Bratus A, Kolling C, Michel BA, Gay RE, Buckley C, Kollias G, Gay S and Ospelt C. Positional coding and noncoding transcriptomes of synovial fibroblasts in joint specific patterns of arthritis. 16th Annual European Congress of Rheumatology – European League Against Rheumatism (EULAR), Rome, Italy, 10 –13/06/2015.

26. Frank Bertoncelj M, Trenkmann M, Klein K, Karouzakis E, Kolling C, Filer A, Buckley C, Michel BA, Gay RE, Gay S and Ospelt C. Joint specific function of synovial fibroblasts – integrating positional transcriptomes and anatomic patterns of arthritis. American College of Rheumatology Annual Meeting, San Francisco, USA, 06 –11/11/2015. 27. Friesenbichler B, Casartelli NC, Item-Glatthorn JF, Wellauer V and Maffiuletti NA. Lower extremity muscle weakness in patients with symptomatic hip osteoarthritis. 75. Jahreskongress der Schweizerischen Gesellschaft für Or Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 25 – 26/06/2015. Swiss Med Wkly 145 (Suppl 210) 38S. 28. Friesenbichler B, Casartelli NC, Item-Glatthorn JF, Wellauer V and Maffiuletti NA. Lower limb muscle weakness in patients with symptomatic hip osteoarthritis. 20th Annual Congress of the European College of Sport Science (ECSS), Malmö, Sweden, 24 – 27/06/2015. 29. Gaur N, Karouzakis E, Jungel A, Frank Bertoncelj M, Bagdonas E, Kolling C, Michel BA, Gay RE, Gay S and Neidhart M. Microrna-29C limits the effects of methyl donors on DNA methylation in rheumatoid arthritis synovial fibroblasts. 16th Annual European Congress of Rheumatology – European League Against Rheumatism (EULAR), Rome, Italy, 10 –13/06/2015. 30. Glanzmann M, Audigé L, Flury M, Schwyzer HK and Kolling C. Was bietet die Konversion zur Hemiprothese beim Versagen einer inversen Schulterprothese ? 22. Jahreskongress der Deutschen Vereinigung für Schulterund Ellenbogenchirurgie (DVSE), Mannheim, Germany, 25 –27/06/2015. 31. Glanzmann M, Kolling C, Flury M, Schwyzer HK and Audigé L. Matched-pair analysis of stemless versus conventional anatomic total shoulder replacement. 75. Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 24 –26/06/2015. Swiss Med Wkly 145 (Suppl 210) 35S. 32. Glanzmann M, Kolling C, Flury M, Schwyzer HK and Audigé L. Schaftfreie vs. konventionelle Schultertotalprothese: eine Matched-pair-Analyse. 22. Jahreskongress der Deutschen Vereinigung für Schulter- und Ellenbogenchirurgie (DVSE), Mannheim, Germany, 25 –27/06/2015. 33. Glück S, Gaur N, Trenkmann M, Karouzakis E, Sun F, Kolling C, Michel BA, Gay RE, Gay S, Neidhart M and Frank Bertoncelj M. Altered histone 3 dynamics at the matrix metalloproteinase 1 (MMP1) transcription start site contributes to MMP1 suppression in betaine supplemented synovial fibroblasts in rheumatoid arthritis. American College of Rheumatology Annual Meeting, San Francisco, USA, 06 –11/11/2015. 34. Grobet C, Flury M, Glanzmann M, Herren D, Hess S and Audigé L. Preliminary cost-utility data about common orthopedic procedures on the upper extremity. 75. Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 24 – 26/06/2015. Swiss Med Wkly 145 (Suppl 210) 74S. 35. Grobet C, Flury M, Glanzmann M, Schwyzer HK, Eichler K and Audigé L. Kosten-Nutzen-Analyse von zwei orthopädischen Interventionen an der Schulter: arthroskopische Rotatorenmanschettenrekonstruktion und Schulterarthroplastik. 22. Jahreskongress der Deutschen Vereinigung für Schulter- und Ellenbogenchirurgie (DVSE), Mannheim, Germany, 25 –27/06/2015.

36. Haschtmann D, Schär R, Sutter M, Mannion AF, Eggspühler A, Fekete T, Kleinstück F and Jeszenszky D. Die Prognose der L5-Radikulopathie nach Reposition und instrumentierter Spondylodese bei hochgradigen isthmischen, lumbosakralen Spondylolisthesen und die Rolle des multimodalen intraoperativen Neuromonitorings. 10. Jahrestagung der Deutschen Wirbelsäulengesellschaft, Frankfurt, Germany, 11/12/2015. 37. Hensler S, Audigé L, Herren D and Schindele S. CapFlexPIP – a modular surface gliding arthroplasty: first mid-term results. 49. Jahreskongress der Schweizerischen Gesellschaft für Handchirurgie (SGH) / 17. Jahreskongress der Schweizerischen Gesellschaft für Handrehabilitation (SGHR), Fribourg, Switzerland, 05 – 06/11/2015. 38. Hensler S, Marks M, Vliet Vlieland TP, van den Hout WB, Schindele S, Audigé L and Herren D. Healthcare costs and loss of productivity in patients with trapeziometacarpal osteoarthritis. 75.  Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 24 – 26/06/2015. Swiss Med Wkly 145 (Suppl 210) 48S. 39. Jeszenszky D, Obid P, Hunyadi R, Haschtmann D, Kleinstück F and Fekete TF. Survival rate after repeat surgery of chordomas of the cervical spine including the cranio-vertebral junction. 75. Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 24 – 26/06/2015. Swiss Med Wkly 145 (Suppl 210) 13S. 40. Jung C and Buchmann S. Nachbehandlung der Rotatorenmanschettenrekonstruktion: Was wissen wir wirklich ? 22. Jahreskongress der Deutschen Vereinigung für Schulterund Ellenbogenchirurgie (DVSE), Mannheim, Germany, 25 – 27/06/2015. 41. Junge A. Epidemiology of injury in women’s football. 8th World Congress on Science & Football, Copenhagen, Denmark, 20 – 23/05/2015. 42. Junge A. FIFA’s research into mental health. XXIV International Conference of Sport Rehabilitation and Traumatology. Football Medicine Strategies for Player Care, London, UK, 11 –12/04/2015. 43. Karouzakis E, Filer A, Eyre S, Raza K, Kolling C, Gay RE, Michel BA, Worthington J, Buckley C, Gay S, Neidhart M and Ospelt C. Genetic and epigenetic mapping of very early RA synovial fibroblasts. American College of Rheumatology Annual Meeting, San Francisco, USA, 06 – 11/11/2015. 44. Kato M, Klein K, Ospelt C, Kolling C, Kono M, Yasuda S, Gay R, Gay S and Atsumi T. AAA-atpase P97 regulates apoptotic and autophagy-associated cell death in arthritis. 16th Annual European Congress of Rheumatology – European League Against Rheumatism (EULAR), Rome, Italy, 10 –13/06/2015. 45. Kato M, Klein K, Ospelt C, Kolling C, Kono M, Yasuda S, Gay RE, Gay S and Atsumi T. AAA-atpase p97-HDAC6 controlled poly-ubiquitin turnover regulates apoptotic and autophagy-associated cell death in arthritis. American College of Rheumatology Annual Meeting, San Francisco, USA, 06 –11/11/2015. 46. Klein K, Gay RE, Kolling C, Ciurea A, Kyburz D, Michel BA, Lin L, Gay S and Ospelt C. Epigenetic mechanisms contribute to the lack of LPS-induced tolerance in rheumatoid arthritis synovial fibroblasts. American College of Rheumatology Annual Meeting, San Francisco, USA, 06 –11/11/2015.

131

List of Publications

47. Klein K, Gay RE, Kolling C, Kato M, Michel B, Gay S and Ospelt C. The bromodomain protein BRD1 regulates the matrix degrading and inflammatory properties of rheumatoid arthritis synovial fibroblasts. 16th Annual European Congress of Rheumatology – European League Against Rheumatism (EULAR), Rome, Italy, 10 –13/06/2015. 48. Kleinstück FS, Haschtmann D, Fekete TF, Jeszenszky D and Mannion AF. A comparative effectiveness study of mini-open versus open transforaminal interbody fusion for lumbar degenerative disorders. 42nd Annual Meeting of the International Society for the Study of the Lumbar Spine (ISSLS), San Francisco, USA, 08 –12/06/2015. 49. Kleinstück FS, Haschtmann D, Fekete TF, Jeszenszky D and Mannion AF. Mini-open versus open transforaminal interbody fusion for lumbar degenerative disorders: a comparative effectiveness study. Eurospine, the Spine Society of Europe, Copenhagen, Denmark, 02 – 04/09/2015. 50. Kolling C, Audigé L, Flury M and Schwyzer HK. Maintenance of a local joint registry for shoulder arthroplasties by a qualified research team. 4th International Congress of Arthroplasty Registries, Gothenburg, Sweden, 23 – 25/05/2015. 51. Krefter C, Calcagni M, Hensler S, Marks M and Herren D. Treatment options and related outcomes in Dupuytren’s disease. A systematic literature review. 20th Congress of the Federation of European Societies for Surgery of the Hand (FESSH), Milan, Italy, 17 – 20/06/2015. J Hand Surg (Eur) 40 (Suppl 1) S134. 52. Krefter C, Marks M, Wehrli M, Hensler S, Herren D and Schindele S. Collagenase injection in Dupuytren‘s disease: observations and conclusion in 203 patients. 75. Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 24 – 26/06/2015. Swiss Med Wkly 145 (Suppl 210) 21S. 53. Mani K, Friesenbichler B and Maffiuletti NA. Reproducibility and validity of an instrumented single-leg hop test in athletes with knee injuries. Return to Play – First World Congress in Sports Physical Therapy, Bern, Switzerland, 20 – 21/11/2015. 54. Manner HM and Velasco R. Treatment of severe foot deformity with the Taylor Spatial Frame. 75. Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 25/6/2015. Swiss Med Wkly 145 (Suppl 210) 18S. 55. Manner HM, Velasco R, Rutishauser T and Rippstein P. The Taylor Spatial Frame used as a compression device for hindfoot re-arthrodesis. 75. Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 24 – 26/06/2015. Swiss Med Wkly 145 (Suppl 210) 16S. 56. Mannion AF, Impellizzeri FM, Naal FD and Leunig M. Gender differences in patient-rated outcomes in total hip replacement: role of preoperative status and expectations. 75. Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 24 – 26/06/2015. Swiss Med Wkly 145 (Suppl 210) 39S. 57. Mannion AF, Müller U, Rolli C, Tamcan O and Elfering A. Pessimistic back beliefs and lack of exercise: a risky combination for future shoulder, neck, and back pain. Eurospine, the Spine Society of Europe, Copenhagen, Denmark, 02 – 04/09/2015. 58. Mannion AF, Mutter UM, Donzelli S, Lusini M, Kleinstück FS, Minnella S, Negrini S and Zaina F. How well can the clinician appraise the severity and impact of a patient’s back problem during the clinical consultation ? Eurospine, the Spine Society of Europe, Copenhagen, Denmark, 02 – 04/09/2015.

132

59. Mannion AF, Vila-Casademunt A, Domingo-Sabat M, Wunderlin S, Pellise F, Acaroglu E, Alanay A, Perez-Grueso FJ, Obeid I and Kleinstück FS. Is the Core Outcome Measures Index (COMI) as responsive as the SRS-22 for the assessment of outcome in adult spinal deformity ? 75. Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 24 – 26/06/2015. Swiss Med Wkly 145 (Suppl 210) 14S. 60. Naal FD, Impellizzeri FM, Lenze U, Wellauer V, von Eisenhart-Rothe R and Leunig M. Clinical improvement and satisfaction after total joint replacement – a prospective 12 months evaluation on the patients’ perspective. 75. Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 24 – 26/06/2015. Swiss Med Wkly 145 (Suppl 210) 39S. 61. Naal FD, Müller AM, Impellizzeri FM, Wellauer V and Leunig M. Midterm results of FAI surgery – association with generalized joint hypermobility ? 75. Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 24 – 26/06/2015. Swiss Med Wkly 145 (Suppl 210) 5S. 62. Neukom L and Herren D. Severe complication of thermal shrinkage in the wrist. 49. Jahreskongress der Schweizerischen Gesellschaft für Handchirurgie (SGH) / 17. Jahreskongress der Schweizerischen Gesellschaft für Handrehabilitation (SGHR), Fribourg, Switzerland, 05 – 06/11/2015. 63. Neukom L, Herren D, Hensler S and Schindele S. Silicone arthroplasty versus screw arthrodesis in distal interphalangeal joint osteoarthritis. 49. Jahreskongress der Schweizerischen Gesellschaft für Handchirurgie (SGH) / 17. Jahreskongress der Schweizerischen Gesellschaft für Handrehabilitation (SGHR), Fribourg, Switzerland, 05 – 06/11/2015. 64. Obid P, Fekete T, Kleinstück FS, Haschtmann D, Pröbstl O and Jeszenszky D. Revisionschirurgie nach inkompletter Chordom-Resektion an der Halswirbelsäule. 10. Jahrestagung der Deutschen Wirbelsäulengesellschaft, Frankfurt, Germany, 11/12/2015. 65. Omair A, Mannion AF, Leivseth G, Fairbank JC, Holden M, Benedicte A, Hagg O, Fritzell P and Brox JI. Age, pro-inflammatory gene polymorphisms and fusion are associated with adjacent segment disc degeneration in patients treated for chronic low back pain. 42nd Annual Meeting of the International Society for the Study of the Lumbar Spine (ISSLS), San Francisco, USA, 08 –12/06/2015. 66. Oswald J. Die postoperative Rotatorenmanschette. 39.Ultraschall-Dreiländertreffen, Davos, Switzerland, 24/09/2015. 67. Oswald J. Differenzierter Schulterultraschall und Bizepssehneninstabilität. 39. Ultraschall-Dreiländertreffen, Davos, Switzerland, 24/09/2015. 68. Oswald J. Hands-on Schulter. 39. Ultraschall-Dreiländertreffen, Davos, Switzerland, 25/09/2015. 69. Plestilova L, Ciurea A, Kolling C, Gay RE, Vencovsky J, Michel BA, Neidhart M, Gay S and Jüngel A. Expression of piwi interacting RNA in rheumatoid arthritis. 16th Annual European Congress of Rheumatology – European League Against Rheumatism (EULAR), Rome, Italy, 10 – 13/06/2015. 70. Pochon L, Kleinstück FS, Fekete TF, Haschtmann D, Jeszenszky D and Mannion AF. Influence of gender on patient-orientated outcomes in spine surgery. 75. Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 24 – 26/06/2015. Swiss Med Wkly 145 (Suppl 210) 50S.

71. Reissner L, Marks M, Schindele S and Herren D. CMC I osteoarthitis: comparison of clinical outcome with subluxation of the first metacarpal base. 20th Congress of the Federation of European Societies for Surgery of the Hand (FESSH), Milan, Italy, 17 – 20/06/2015. J Hand Surg (Eur) 40 (Suppl 1) S2. 72. Rössler R, Junge A, Chomiak J, Dvořák J and Faude O. Fussballverletzungen bei 7- bis 12-jährigen Spielern: Eine deskriptive epidemiologische Studie über zwei Saisons. 46. Deutschen Sportärztekongress, Frankfurt, Germany, 11 –12/09/2015. 73. Rössler R, Junge A, Chomiak J and Faude O. The relative age effect and injuries in children’s football. 20th Annual Congress of the European College of Sport Science (ECSS), Malmö, Sweden, 24 – 27/06/2015. 74. Sakuma Y, Kensuke O, Schindele S, Momohara S and Herren D. Attritional tendon rupture of flexor tendon of the finger caused by severe chronic volar subluxation of metacarpophalangeal joint in the patients of rheumatoid arthritis. 20th Congress of the Federation of European Societies for Surgery of the Hand (FESSH), Milan, Italy, 17 – 20/06/2015. 75. Schär R, Sutter M, Mannion AF, Eggspühler A, Jeszenszky D, Fekete TF, Kleinstück FS and Haschtmann D. Prognose der L5-Radikulopathie nach Reposition und instrumentierter Spondylodese bei hochgradigen adulten isthmischen, lumbosakralen Spondylolisthesen und die Rolle des multimodalen intraoperativen Neuromonitorings. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie, Karlsruhe, Germany, 08/06/2015. 76. Schär R, Sutter M, Mannion AF, Eggspühler A, Jeszenszky D, Fekete TF, Kleinstück FS and Haschtmann D. The prognosis of L5 radiculopathy after reduction and instrumented fusion of adult isthmic high-grade lumbosacral spondylolisthesis and the role of multimodal intraoperative neuromonitoring (MIOM). Eurospine, the Spine Society of Europe, Copenhagen, Denmark, 02 – 04/09/2015. 77. Schär R, Sutter M, Mannion AF, Eggspühler A, Jeszenszky D, Fekete TF, Kleinstück FS and Haschtmann D. The prognosis of L5 radiculopathy after reduction and instrumented fusion of adult isthmic high-grade lumbosacral spondylolisthesis and the role of multimodal intraoperative neuromonitoring (MIOM). 42nd Annual Meeting of the International Society for the Study of the Lumbar Spine (ISSLS), San Francisco, USA, 08 –12/06/2015. 78. Schär R, Sutter M, Mannion AF, Eggspühler A, Jeszenszky D, Fekete TF, Kleinstück FS and Haschtmann D. The prognosis of L5 radiculopathy after reduction and instrumented fusion of adult isthmic high-grade lumbosacral spondylolisthesis and the role of multimodal intraoperative neuromonitoring (MIOM). Joint Annual Meeting of the Swiss Society of Neurosurgery and the Swiss Society of Neuroradiology, Lucerne, Switzerland, 10/09/2015. 79. Schär R, Sutter M, Mannion AF, Eggspühler A, Jeszenszky D, Fekete TF, Kleinstück FS and Haschtmann D. The prognosis of L5 radiculopathy after reduction and instrumented fusion of adult isthmic high-grade lumbosacral spondylolisthesis and the role of multimodal intraoperative neuromonitoring (MIOM). 75. Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 24 – 26/06/2015. 80. Schindele S, Hensler S, Audigé L and Herren D. CapFlex-PIP © – eine modulare Oberflächenprothese. Erste mittelfristige Ergebnisse. 56. Kongress der Deutschen Gesellschaft für Handchirurgie (DGH) & 20.  Jahreskongress der Deutschen Arbeitsgemeinschaft für Handtherapie (DAHTH) e. V., Ludwigsburg, Germany, 24 – 26/09/2015.

81. Schneider MM, Audigé L, Zenk E, Schwyzer HK and Flury M. Hat der Schaft-Hals-Winkel der humeralen Komponente einer inversen Schulterarthroplastik einen Einfluss auf das postoperative Outcome ? 22. Jahreskongress der Deutschen Vereinigung für Schulter- und Ellenbogenchirurgie (DVSE), Mannheim, Germany, 25 –27/06/2015. 82. Schneider MM, Harder L, Preiss S, Bruhin V and Salzmann G. Destructive chondrolysis following intraarticular application of Lavasorb (Polihexanid) for treatment of knee empyema. 75.  Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 24 – 26/06/2015. Swiss Med Wkly 145 (Suppl 210) 55S. 83. Tange C, Engler A, Kolling C, Filer A, Buckley C, Michel BA, Gay RE, Gay S and Ospelt C. Reduced expression of Mir204 in early RA promotes inflammatory pathways in synovial fibroblasts. American College of Rheumatology Annual Meeting, San Francisco, USA, 06 –11/11/2015. 84. Thoma A. Anämie als unabhängiger Prädiktor radiologischer Progression bei RA. 16t h Annual European Congress of Rheumatology – European League Against Rheumatism (EULAR), Rome, Italy, 10 –12/06/2015. 85. Thoma A. Antibiotic treatment for chronic low back pain – practical consideration. Jahreskongress der Schweizerischen Gesellschaft für Rheumatologie (SGR), Lausanne, Switzerland, 11/09/2015. 86. Thoma A. Behandlung Psoriasisarthritis; Vergleich Dermatologen vs. Rheumatologen. Daten aus der globalen ALIGN-Studie. 16t h Annual European Congress of Rheumatology – European League Against Rheumatism (EULAR), Rome, Italy, 10 –12/06/2015. 87. Thoma A. Moderation: Workshop Überblick Osteoporose. 56. Jahreskongress der Schweizerische Gesellschaft für Manuelle Medizin (SAMM), Interlaken, Switzerland, 26 – 28/11/2015. 88. Thoma A. Osteoporose-Therapiewirksamkeit im Alltag, Behandlungsdauer. Hausarztfortbildung Bone Academy, Zurich, Switzerland, 02/07/2015. 89. Wehrli M, Hensler S, Schindele S, Herren D and Marks M. Measurement properties of brief Michigan hand outcomes questionnaire in patients with Dupuytren’s disease. 20th Congress of the Federation of European Societies for Surgery of the Hand (FESSH), Milan, Italy, 17 – 20/06/2015. J Hand Surg (Eur) 40 (Suppl 1) S42. 90. Wehrli M, Marks M, Krefter C and Herren D. Behandlungsmethoden von Morbus Dupuytren in der Schweiz: Ergebnisse einer Delphi-Studie. 49. Jahreskongress der Schweizerischen Gesellschaft für Handchirurgie (SGH) / 17. Jahreskongress der Schweizerischen Gesellschaft für Handrehabilitation (SGHR), Fribourg, Switzerland, 05 – 06/11/2015. 91. Wellauer V, Item-Glatthorn JF, von Knoch F and Maffiuletti NA. Knee, muscle and physical function of patients six months after partial vs. total knee arthroplasty: some preliminary results. 75. Jahreskongress der Schweizerischen Gesellschaft für Orthopädie und Traumatologie (SGOT), Basel, Switzerland, 24 – 26/06/2015. Swiss Med Wkly 145 (Suppl 210) 55S. 92. Wirth B, Flury M, Schwyzer HK and Audigé L. Are there predicting factors for internal rotation outcome after reverse shoulder arthroplasty ? 26th Congress of the European Society for Surgery of the Shoulder and Elbow (SECEC), Milan, Italy, 16 –19/09/2015.

93. Wirth B, Flury M, Schwyzer HK and Audigé L. Prognostische Faktoren für die Innenrotation nach inverser Schulterprothese. 22. Jahreskongress der Deutschen Vereinigung für Schulter- und Ellenbogenchirurgie (DVSE), Mannheim, Germany, 25 –27/06/2015. 94. Zaina F, Mutter UM, Donzelli S, Lusini M, Kleinstück FS, Minnella S, Negrini S and Mannion AF. Can the clinician accurately appraise the severity and impact of a patient’s back problem during the clinical consultation ? 42nd Annual Meeting of the International Society for the Study of the Lumbar Spine (ISSLS), San Francisco, USA, 08 – 12/06/2015.

Lectures and advanced training

17. Dvořák J. 20 years of F-MARC. 3rd FIFA Medical Conference, Zurich, Switzerland, 28 – 29/05/2015. 18. Dvořák J. 20 years of F-MARC, AFC presidential award lecture. 5th AFC Medical Conference, New Delhi, India, 27/11 – 01/12/2015. 19. Dvořák J. FIFA 11 for Health. Meeting with Dr. J. Coleman, Minister for Sport and Recreation, Auckland, New Zealand, 06 –10/02/2015. 20. Dvořák J. Football for health. International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS), Lyon, France, 05 – 08/06/2015. 21. Dvořák J. Prevention in football. FIFA Medical Centre of Excellence Inauguration, Kobe, Japan, 26/01/2015.

1.

Bizzini M. FIFA referee selections and PCMA. 5th AFC Medical Conference, New Delhi, India, 30/11 – 02/12/2015.

22. Dvořák J. Prevention of sudden cardiac death in football. European Society of Cardiology/ Europrevent, Lisbon, Portugal, 14 –15/05/2015.

2.

Bizzini M. Football referees: injuries and prevention. 5th AFC Medical Conference, New Delhi, India, 30/11 – 02/12/2015.

23. Dvořák J. What has spine to do with football ? International Society for the Advancement of Spine Surgery (ISASS), San Diego, USA, 16/04/2015.

3.

Bizzini M. Injury prevention in football: an update. ICRS Focus Meeting. Rehabilitation & Return to Sports, Zurich, Switzerland, 18 –19/09/2015.

24. Feddermann-Demont N. Concussion – return to play & prevention. 3rd FIFA Medical Conference, Zurich, Switzerland, 27/05/2015.

4.

Bizzini M. Return to football after ACL surgery. 5th AFC Medical Conference, New Delhi, India, 30/11 – 02/12/2015.

5.

Bizzini M. Return to play after hip surgery in pro ice hockey players. 1st Sports Physical Therapy Congress, Helsinki, Finland, 20 – 21/03/2015.

25. Feddermann-Demont N. Diagnostisches und therapeutisches Management nach Kopfverletzungen im Fussball. Fliegerärztliches Symposium, Department of Exercise and Health, Paderborn University, Paderborn, Germany, 15/04/2015.

6.

Bizzini M. Return to sport after hip surgery in athletes. ICRS Focus Meeting. Rehabilitation & Return to Sports, Zurich, Switzerland, 18 –19/09/2015.

7.

Bizzini M. Return to sports after hip surgery. 5th AFC Medical Conference, New Delhi, India, 30/11 – 02/12/2015.

8.

Bizzini M, Haratian Z and Eiles M. FIFA 11+ worldwide. 3rd  FIFA Medical Conference, Zurich, Switzerland, 27 – 28/05/2015.

9.

Bizzini M, Junge A and Dvořák J. FIFA 11+ implementation strategy. 3rd FIFA Medical Conference, Zurich, Switzerland, 27 – 28/05/2015.

10. Bizzini M, Junge A and Dvořák J. FIFA 11+ injury prevention programme. 5th AFC Medical Conference, New Delhi, India, 30/11 – 02/12/2015.

26. Feddermann-Demont N. Diagnostisches und therapeutisches Management nach sportassoziierter Kopfverletzung im Hinblick auf eine frühe und sichere «Rückkehr zu Training und Spiel». 46. Deutsche Sportärztekongress, Frankfurt, Germany, 12/09/2015. 27. Feddermann-Demont N. F-MARC studies. NFL Think Tank, London, UK, 24/10/2015. 28. Feddermann-Demont N. Head injuries and concussion: screening, diagnosis and management. UEFA Football Doctor Education Programme, Budapest, Hungary, 29/04/2015. 29. Feddermann-Demont N. Kurz- und mittelfristiges Management von Gehirnerschütterungen im Fussball. Bundesliga Ärztetagung, Frankfurt, Germany, 12/08/2015.

11. Bruppacher H. Der einfache Simulator. 14. St. Galler Airway Management Symposium, St.  Gallen, Switzerland, 20/11/2015.

30. Feddermann-Demont N. The right management of head injuries (including concussion). XXIV International Conference of Sport Rehabilitation and Traumatology. Football Medicine Strategies for Player Care, London, UK, 12/04/2015.

12. Bruppacher H. Simulation. Geht es auch einfach ? 14. St. Galler Airway Management Symposium, St. Gallen, Switzerland, 20/11/2015.

31. Feddermann-Demont N. Swiss Concussion Project. 4th International Initiative for Traumatic Brain Injury Research ter (InTBIR) Meeting, Brussels, Belgium, 13 –14/10/2015.

13. Dietrich E. Resektions-Interpositionsarthroplastik des Daumensattelgelenkes: Braucht es eine Thermoplastschiene ? 56. Kongress der Deutschen Gesellschaft für Handchirurgie (DGH) & 20. Jahreskongress der Deutschen Arbeitsgemeinschaft für Handtherapie (DAHTH) e. V, Ludwigsburg, Deutschland, 24. – 26.09.2015.

32. Feddermann-Demont N. Swiss Concussion Project: improvement of return to play after head injury in football. Demonstration Week Health Sciences and Technology at the Swiss Federal Institute of Technology (ETH), Schulthess Clinic, Zurich, Switzerland, 02 – 05/02/2015.

14. Dvořák J. 11 against Ebola. Ministry of Health, Freetown, Sierra Leone, 31/10 – 02/11/2015. 15. Dvořák J. 11 for Health – FIFA perspective. 8th World Congress on Science & Football, Copenhagen, Denmark, 19 – 21/05/2015.

33. Feddermann-Demont N. Swiss Concussion Project: improvement of return to play after head injury in football; Management von Fussballspielern mit Schwindel nach Kopftrauma: Commotio cerebri vs. Commotio labyrinthi. 27. Kolloquium der Medizinischen Kommission Schweizer Fussballverband (SFV), Muri, Switzerland, 10/01/2015.

16. Dvořák J. 20 years of F-MARC. American Medical Society for Sports Medicine (AMSSM), Miami, USA, 14 –15/04/2015.

133

List of Publications

34. Flury M. Die Kombination inverser Schulterprothese mit Latissimus dorsi Transfer: subjektive und objektive Resultate. Salzburger Schulterforum: Endoprothetik des Schulter Schultergelenkes, Salzburg, Austria, 03 – 04/12/2015.

54. Harder L. Hinteres Kreuzband – Verletzungen, Diagnose und Therapie. Hausarztfortbildung: Was gibt es Neues in der Kniechirurgie ? Schulthess Clinic, Zurich, Switzerland, 17/09/2015.

35. Flury M. Die Prothese nach Humeruskopffraktur: Indikation und Resultate. Salzburger Schulterforum: Endoprothetik des Schultergelenkes, Salzburg, Austria, 03 – 04/12/2015.

55. Harder L. Moderne Indikationsstellung des teilendoprothetischen Ersatzes. Sigma HP Partial Knee Instructional Course, Zurich, Switzerland, 25/09/2015.

72. Herren D. What’s in and what’s out in hand surgery. 20th Congress of the Federation of European Societies for  Surgery of the Hand (FESSH), Milan, Italy, 17 – 20/06/2015.

36. Flury M. Die Rekonstruktion der Subscapularis-Sehne. 7. Tegernseer Schulter- und Ellenbogenkurs, Wildbad Kreuth, Germany, 15 –18/07/2015.

56. Harder L. Neue Systeme und Technologien in der Arthroplastik. Symposium Firma Zimmer, Zurich, Switzerland, 27/11/2015.

73. Impellizzeri FM. Chronic and acute effects of the FIFA injury prevention program: the 11+. First Palmeiras Congress on Science in Football, São Paulo, Brazil, 09 –11/10/2015.

37. Flury M. Live OP: rotator cuff repair. 7. Schulter Tagung, Bern, Switzerland, 02 – 03/07/2015.

57. Harder L. OP Technik Sigma Partial Knee / Tipps & Tricks. Sigma HP Partial Knee Instructional Course, Zurich, Switzerland, 25/09/2015.

74. Impellizzeri FM. Evaluating patient factors: can we predict outcomes ? AOTrauma Symposium – Surgical Preservation of the Hip, Salt Lake City, USA, 08 –10/01/2015.

58. Harder L. Revisionseingriffe nach HTO und Schlittenprothesen. Sigma HP Partial Knee Instructional Course, Zurich, Switzerland, 25/09/2015.

75. Impellizzeri FM. How should we define a good result ? AOTrauma Symposium – Surgical Preservation of the Hip, Salt Lake City, USA, 08 –10/01/2015.

59. Harder L. Was ich über die Knieprothese wissen muss. Publikumsveranstaltung, Schulthess Clinic, Zurich, Switzerland, 09/04/2015.

76. Impellizzeri FM. Optimal current instruments to evaluate outcomes: a pragmatic approach. AOTrauma Symposium – Surgical Preservation of the Hip, Salt Lake City, USA, 08 – 10/01/2015.

38. Flury M. Moderation: Die komplexe Rotatorenmanschettenruptur. 32. Kongress der Gesellschaft für Arthroskopie und Gelenkchirurgie (AGA), Dresden, Germany, 17 – 19/09/2015. 39. Flury M. Offene vs. arhtroskopische Rekonstruktion. AFOR Kurs für Ärzte, Pontresina, Switzerland, 01– 06/02/2015. 40. Flury M. RM, Patch. 32. Kongress der Gesellschaft für Arthroskopie und Gelenkchirurgie (AGA), Dresden, Germany, 17 –19/09/2015. 41. Flury M. Rotatorenmanschette I: SSP-Rekonstruktion – my technique. 20. Internationaler Schulterkurs München, Munich, Germany, 28 – 30/09/2015. 42. Flury M. Rotatorenmanschettenruptur – differenziertes operatives Vorgehen. 33. Arthroskopiekurs Arosa, Arosa, Switzerland, 18 – 23/01/2015. 43. Flury M. Stabilisierung des AC-Gelenkes. 33. Arthroskopiekurs Arosa, Arosa, Switzerland, 18 –23/01/2015. 44. Friesenbichler B and Maffiuletti NA. Lower extremity muscle strength in patients before total hip arthroplasty. 5th Partner Assembly for the LifeLongJoints project, Uppsala, Sweden, 03 – 04/02/2015. 45. Fuller CW and Junge A. FIFA 11 for Health. Implementation strategy. 3rd FIFA Medical Conference, Zurich, Switzerland, 27 – 28/05/2015. 46. Glanzmann MC. AC-Separation und Hochleistungssport – wer operativ und wer konservativ ? 2. Spätsommersymposium Frankfurt, Frankfurt, Germany, 04 – 05/09/2015. 47. Glanzmann MC. Begleitverletzungen der Schultereckgelenks-Separation – welche Diagnostik benötige ich ? 2. Spätsommersymposium Frankfurt, Frankfurt, Germany, 04 – 05/09/2015. 48. Glanzmann MC. Die Terrible-Triad-Verletzung des Ellbogen: Wie erkennen, wie behandeln. Deutscher Ellbogenkongress, Marburg, Germany, 27/11/2015. 49. Glanzmann MC. Mythos Plica – Evidenz zu Klinik und Therapie. Köln-Pforzheimer Ellenbogentage, Cologne, Germany, 10 –12/09/2015. 50. Guggi T. Blind nach Hüftrevision – eine neurotoxische Reaktion. 8. Endoprothetikkongress Berlin, Berlin, Germany, 26 – 28/02/2015. 51. Harder L. Erste Erfahrungen mit Attune. Expertenrunde Surgery Week DePuy / Synthes, Vienna, Austria, 15/04/2015. 52. Harder L. Fallbesprechungen. Morbidity- / Mortality-Fortbildungen, Schulthess Clinic, Zurich, Switzerland, 23/03/2015, 28/09/2015, 07/12/2015. 53. Harder L. FuZion – neue Möglichkeiten für das Soft Tissue Balancing. Masterclass Persona, Zurich, Switzerland, 27/08/2015.

134

60. Hartmann K. Moderation: lecture I. 49. Jahreskongress der Schweizerischen Gesellschaft für Handchirurgie (SGH) / 17. Jahreskongress der Schweizerischen Gesellschaft für Handrehabilitation (SGHR), Fribourg, Switzerland, 05 – 06/11/2015. 61. Haschtmann D. Design of biomechanical systems lecture: “Introduction and Clinical Perspective”. University of Bern, Biomedical Engineering Master Course, Bern, Switzerland, 17/09/2015. 62. Haschtmann D. Posterior approaches and decompression techniques of the lumbar spine. Synthes Spine Academy, Zuchwil, Switzerland, 20/05/2015. 63. Herren D. CapFlex-PIP a new modular surface gliding implant arthroplasty. First midterm results. 6th Combined Meeting of the American Society for Surgery of the Hand and Japanese Society for Surgery of the Hand, Maui, USA, 29/03 – 01/04/2015. 64. Herren D. Chronische Schmerzen. 49. Jahreskongress der Schweizerischen Gesellschaft für Handchirurgie (SGH) / 17. Jahreskongress der Schweizerischen Gesellschaft für Handrehabilitation (SGHR), Fribourg, Switzerland, 05 – 06/11/2015. 65. Herren D. Collagenase: what did we learn in the first 200 cases ? M. Dupuytren in the era of collagenase – where do we stand, where do we go ? Zurich, Switzerland, 11/12/2015. 66. Herren D. Complications of PIP joint fractures and their possible treatment strategies. Federation of European Societies for Surgery of the Hand (FESSH) Course, Markgröningen, Germany / Strasbourg, France, 17 –18/04/2015. 67. Herren D. Difficult problems: malunion of finger fractures. British Society for Surgery of the Hand Course, Manchester, UK, 12 –13/06/2015. 68. Herren D. Indications in inflammatory wrists. 49. Jahreskongress der Schweizerischen Gesellschaft für Handchirurgie (SGH) / 17. Jahreskongress der Schweizerischen Gesellschaft für Handrehabilitation (SGHR), Fribourg, Switzerland, 05 – 06/11/2015. 69. Herren D. PIP arthroplasty with two component implants including resurfacing. University Hospital Zurich Arthroplasty Course, Zurich, Switzerland, 30/01/2015. 70. Herren D. PIP Arthroplasty: how I do it: instructional course. Antwerp Upper Limb Course Antwerp, Belgium, 23 – 24/10/2015.

71. Herren D. Total wrist fusion in the rheumatoid wrist. Eastern European Course on Hand Surgery, Hajdúszoboszló, Hungary, 04 – 06/09/2015.

77. Jörn Good U and Dietrich E. Workshop: Einsatz des biomechanisch optimierten Schienenauslegers ISOFORCE zur Behandlung von Kontrakturen am PIP. 56. Kongress der Deutschen Gesellschaft für Handchirurgie (DGH) & 20. Jahreskongress der Deutschen Arbeitsgemeinschaft für Handtherapie (DAHTH) e. V, Ludwigsburg, Germany, 24 – 26/09/2015. 78. Jung C. Nachbehandlung der Rotatorenmanschetten-rekonstruktion: Was wissen wir wirklich ? 14. Sporttraumatologie Symposium, Stuttgart, Germany, 05/12/2015. 79. Jung C. Rotator cuff repair techniques. Arthrex Naples Lab Course, Naples, USA, 10 –15/01/2015. 80. Jung C. Schulterinstabilität. Eine praxisnahe Fortbildung über Schulter- und Ellbogenverletzung, Schulthess Clinic, Zurich, Switzerland, 18/06/2015. 81. Jung C. Sehnenverletzungen der oberen Extremität – Proximale Bizepssehne. 12. Allgäuer Symposium Orthopädische Chirurgie, Pfronten, Deutschland, 03. – 04.07.2015. 82. Jung C. Shoulder arthroplasty. Swiss Federal Institute of Technology (ETH) Lecture, Zurich, Switzerland, 09/12/2015. 83. Jung C. Shoulder instability. Arthrex Naples Lab Course, Naples, USA, 10 –15/01/2015. 84. Jung C. Traumatische anteriore Erstluxation – konservative vs. operative Therapie. 14. Bogenhausener Schultersymposium, Munich, Germany, 20 – 21/11/2015. 85. Junge A. FIFA’s research projects on mental health. Mental Health in Sport 2015 – Game Changing Mental Health Conference, London, UK, 28/07/2015. 86. Junge A. Injuries – epidemiology in men and women. 3rd FIFA Medical Conference, Zurich, Switzerland, 27 – 28/05/2015. 87. Junge A. Mental health. 3rd FIFA Medical Conference, Zurich, Switzerland, 27 – 28/05/2015. 88. Kleinstück FS. Clinical challenges in musculoskeletal disorders spinal deformities. Swiss Federal Institute of Technology (ETH) Lecture, Schulthess Clinic, Zurich, Switzerland, 20/04/2015. 89. Kleinstück FS. Degenerative Erkrankungen der Wirbelsäule. Grand Rounds, Schulthess Clinic, Zurich, Switzerland, 10/01/2015.

90. Kleinstück FS. Operative Behandlung bei hochgradiger Spondylolisthese und Spondyloptose. Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU), Berlin, Germany, 22/10/2015. 91. Kleinstück FS. Options in corrective spinal surgery. Advanced Sagittal Alignment and Osteotomy Instructional Course, Barcelona, Spain, 25/06/2015.

108. Maffiuletti NA. (1) The contribution of modern strength training to rehabilitation and prevention. (2) Toward a better application of neuromuscular electrical stimulation in sports physical therapy. 4th Salzburger Sportphysiosymposium, Salzburg, Austria, 02 – 03/10/2015. 109. Maffiuletti NA. Basi neuromuscolari della forza e nuovi approcci. Seminario Tecnico CONI, Rome, Italy, 04/04/2015.

92. Kramers-de Quervain I. Berufswahl und Arbeitseingliederung bei entzündlichen Erkrankungen, illustrative Fälle. Jahreskongress der Schweizerischen Gesellschaft für Rheumatologie (SGR), Lausanne, Switzerland, 10 –11/09/2015.

110. Maffiuletti NA. Blessure au genou: ce qu’il faut savoir et ce qu’il faudrait proposer en réhabilitation. 28th Medical Congress Swiss Football Association, Bern, Switzerland, 08/01/2015.

93. Kramers-de Quervain I. Clinical and movement biomechanics: clinical interpretation of gait data. Swiss Federal Institute of Technology (ETH) Lecture, Zurich, Switzerland, 02/12/2015.

111. Maffiuletti NA. Il rate of force development: la variabile neuromuscolare del XXI secolo. 12° Convegno Nazionale di Medicina e Scienza dello Sport, Saronno, Italy, 14/03/2015.

94. Kramers-de Quervain I. Degenerative and rheumatic diseases. Swiss Federal Institute of Technology (ETH) Lecture, Schulthess Clinic, Zurich, Switzerland, 30/03/2015.

112. Maffiuletti NA. Neuromuscular electrical stimulation: let’s talk about the evidence. Nuevos avances en Biomecánica Clínica y función neuromuscular, Pamplona, Spain, 06/10/2015.

95. Kramers-de Quervain I. Weiterbildungskurs Biomechanik für Fachärzte Physikalische Medizin und Rehabilitation. Fortbildung, Zurich, Switzerland, 01/10/2015. 96. Kündig S. Xiapex Training. Schulthess Clinic Xiapex Extension, Zurich, Switzerland, 26/10/2015. 97. Lanz C. Gangstörungen im Alter aus neurologischer Sicht. Technopark Allgemeine Innere Medizin Forum für medizinische Fortbildung, Zurich, Switzerland, 06/11/2015. 98. Leunig M. Abklärung und Behandlung der Hüftarthrose. iNetz interdisziplinäres Netzwerk Zürich, Osteoporose und Arthrose, Zurich, Switzerland, 25/11/2015. 99. Leunig M. The adolescent hip in 2015: controversies and complication prevention, proper analysis of standardized imaging / accurate diagnostic strategies. 81st  Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), Las Vegas, USA, 24 – 27/03/2015. 100. Leunig M. The CAM deformity: avoiding under / over correction. 11th 11t Symposium on Joint Preserving and Minimally Invasive Surgery of the Hip, Ottawa, Canada, 04 – 06/06/2015. 101. Leunig M. Cartilage repair: what is the available science ? AOTrauma Symposium – Surgical Preservation of the Hip, Salt Lake City, USA, 08 – 10/01/2015. 102. Leunig M. Direct anterior approach for THR. 10th International Congress of the Chinese Orthopaedic Association (COA), Chongqing, China, 19 – 22/11/2015. 103. Leunig M. Femoral derotation osteotomy for the treatment of torsional malalignment: when and where ? AOTrauma Symposium – Surgical Preservation of the Hip, Salt Lake City, USA, 08 –10/01/2015. 104. Leunig M. Indications of open surgery. 27th Annual Knee & Hip Course, New York, USA, 03 – 05/12/2015. 105. Leunig M. Mechanical pain of hips: mechanism, evaluation and management. 10th International Congress of the Chinese Orthopaedic Association (COA), Chongqing, China, 19 – 22/11/2015. 106. Leunig M. Operative Behandlung von residuellen Deformitäten im Erwachsenenalter nach M. Legg-Calvé-Perthes. Komplexe Hüftchirurgie 2015, Munich, Germany, 26 – 27/06/2015. 107. Leunig M. Worldwide trend in TJR recovery protocols: surgical approach – does it matter ? 81st Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), Las Vegas, USA, 24 – 27/03/2015.

113. Maffiuletti NA. Nuovi approcci tecnologici per la valutazione di composizione co rporea e performance neuromuscolare. 1° Convegno Nazionale Società Italiana Endocrinologia, Turin, Italy, 12/02/2015.

126. Mannion AF. How to get best out of the system: implementing Tango in a large tertiary care spine centre. International Spine Tango Users Meeting, Bern, Switzerland, 09/10/2015. 127. Mannion AF. Rehabilitation after surgical decompression. Eurospine Lunch Symposium 2, Rehabilitation impact on spinal surgery. Eurospine, the Spine Society of Europe, Copenhagen, Denmark, 02/09/2015. 128. Mannion AF and Sobottke R. Discussion round: diagnostic groups in spine surgery. International Spine Tango Users Meeting, Bern, Switzerland, 09/10/2015. 129. Mannion AF and Staub L. Prediction models of patient outcomes in Schulthess Clinic (study). International Spine Tango Users Meeting, Bern, Switzerland, 09/10/2015. 130. Marks M. Innovations around the body – what are the shortcuts ? Swiss Federal Institute of Technology (ETH) Lecture, Zurich, Switzerland, 16/10/2015. 131. Moro F. Die Anconeus Interpositionsarthroplastik am Ellbogengelenk in der posttraumatischen Situation. AO Trauma Symposium – “Grenzen und Fallstricke von Osteosynthese Techniken”, Fischingen Abbey, Switzerland, 08/05/2015.

114. Maffiuletti NA. Optimizing muscle function in RTP. Return to Play – First World Congress in Sports Physical Therapy, Bern, Switzerland, 21/11/2015.

132. Moro F. Die chirurgischen Prinzipien in der Behandlung von osteoporotischen Frakturen. Osteoporose Publikumsanlass, Schulthess Clinic, Zurich, Switzerland, 24/03/2015.

115. Maffiuletti NA. Physiological and hormonal responses and adaptations to resistance exercise. 3rd Combo Endocrinology International Course, Athens, Greece, 01/10/2015.

133. Moro F. Frakturversorgung / Revision. Schulthess Clinic. Eine praxisnahe Fortbildung über Schulter- und Ellbogenverletzung, Zurich, Switzerland, 18/06/2015.

116. Maffiuletti NA. Rate of force development: its response to acute exercise and chronic physical training. 20th Annual Congress of the European College of Sport Science (ECSS), Malmo, Sweden, 25/06/2015.

134. Moro F. Meine Erfahrungen mit der Ellbogenprothese. 31. Nürnberger Arthroskopiekurs mit Gelenksymposium, Nuremberg, Germany, 02 – 05/12/2015.

117. Maffiuletti NA. The use of neuromuscular electrical stimulation in health and disease: what’s the evidence ? University of Potsdam Master of Clinical Exercise Science Seminar, Potsdam, Germany, 04/02/2015. 118. Manner HM. Limb deficiencies: case discussions. Child Summit Meeting, Utrecht, Netherlands, 22/01/2015. 119. Manner HM. Limb deformities. Swiss Federal Institute of Technology (ETH) Lecture, Schulthess Clinic, Zurich, Switzerland, 16/02/2015. 120. Manner HM. Möglichkeiten der Beinverlängerung. Kleinwuchstreffen, Forch, Switzerland, 14/11/2015. 121. Manner HM. Taylor Spatial Frame in the femur. Taylor Spatial Frame Masterclass, Vienna, Austria, 20 –22/05/2015. 122. Manner HM. Taylor Spatial Frame in the foot: hardware – software – fixation. Complex Foot & Ankle and Deformity Corrections – Instructional Course, Barcelona, Spain, 01/10/2015.

135. Moro F. Periprosthetic fractures in upper limb. Ortho / Trauma Symposium, LIMA Corporate, Muttenz, Switzerland, 19 –20/06/2015. 136. Moro F. Periprothetische Frakturen des Ellenbogens. Köln-Pforzheimer Ellenbogentage, Cologne, Germany, 10 – 12/09/2015. 137. Moro F. Stellenwert der Anconeus Interpositionsarthroplastik. Köln-Pforzheimer Ellenbogentage, Cologne, Germany, 10 – 12/09/2015. 138. Moro F. Treatment of shoulder girdle fractures, history: overview. Ortho / Trauma Symposium, LIMA Corporate, Muttenz, Switzerland, 19 –20/06/2015. 139. Naal FD. The anterior approach for total hip arthroplasty – history and evolution. Johnson and Johnson Instructional Course, Basel, Switzerland, 29/10/2015. 140. Naal FD. Decision algorithm in complex deformities. 2nd International Lisbon Hip Symposium, Lisbon, Portugal, 13 –14/11/2015.

123. Manner HM. Wires and pins – application of the Taylor Spatial Frame. Taylor Spatial Frame Masterclass, Vienna, Austria, 20 – 22/05/2015.

141. Naal FD. The direct anterior approach – preoperative preparation and patient selection. Johnson and Johnson Instructional Course, Basel, Switzerland, 29/10/2015.

124. Manner HM and Rippstein P. Experience with the Taylor Spatial Frame in the foot: special indication: hindfoot arthrodesis. Complex Foot & Ankle and Deformity Corrections – Instructional Course, Barcelona, Spain, 01/10/2015.

142. Naal FD. Fallvorstellungen Femoroacetabuläres Impingement. Schulthess Clinic Hausarztfortbildung: Die klinische und radiologische Abklärung des Hüftgelenks, Zurich, Switzerland, 22/10/2015.

125. Mannion AF. Assessment of complications after spine surgery: time for a paradigm shift ? International Spine Tango Users Meeting, Bern, Switzerland, 09/10/2015.

143. Naal FD. Hüftarthrose: Von der Einzelfallbeschreibung zu systematischen Studien. Demonstration Week Health Sciences and Technology at the Swiss Federal Institute of Technology (ETH), Schulthess Clinic, Zurich, Switzerland, 03 – 05/02/2015.

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144. Naal FD. Minimal-invasive Hüftendoprothetik – Hype oder logische Evolution ? School of Medicine Council Meeting, Technical University of Munich (TUM), Munich, Germany, 15/07/2015. 145. Naal FD. Periacetabular osteotomy – surgical technique. 2nd International Lisbon Hip Symposium, Lisbon, Portugal, 13 – 14/11/2015.

List of Publications

146. Naal FD. Session: hip dysplasia I. 2nd International Lisbon Hip Symposium, Lisbon, Portugal, 13 – 14/11/2015. 147. Naal FD. Session: risk factors for developing osteoarthritis & patient selections to hip preservation. 2nd International Lisbon Hip Symposium, Lisbon, Portugal, 13 –14/11/2015. 148. Naal FD. Surgical hip dislocation complications. 2nd International Lisbon Hip Symposium, Lisbon, Portugal, ter 13 –14/11/2015. 149. Oswald J. Die lange Bizepssehne: eine in Funktion und Pathologie oft unterschätzte anatomische Struktur. 7. Schulter Tagung, Bern, Switzerland, 02/07/2015. 150. Oswald J. Sonographie der Rotatorenmanschette. 7. Schulter Tagung, Bern, Switzerland, 03/07/2015. 151. Porchet F. The impact of obesity on the outcome of decompression surgery in degenerative lumbar spinal canal stenosis: a Swiss prospective cohort multicenter study. Joint Annual Meeting of the Swiss Society of Neurosurgery and the Swiss Society of Neuroradiology, Lucerne, Switzerland, 10 –11/09/2015. 152. Porchet F. Ist spinale Computertomographie intraoperativ notwendig ? University Hospital Zurich (USZ) Clinical Neurology Centre, Zurich, Switzerland, 29/10/2015. 153. Porchet F. Neurochirurgische Therapie an der Wirbelsäule: vom Nacken zum Steissbein. Kivadis Weiterbildung, Rapperswil, Switzerland, 09/04/2015. 154. Porchet F. Neuromonitoring during spine surgery. European Association of Neurosurgical Societies (EANS) Symposium, Verona, Italy, 14 –16/06/2015. 155. Porchet F. Overview of degenerative spine disease, biomechanical aspects of the cervical spine. Swiss Federal Institute of Technology (ETH) Lecture, Schulthess Clinic, Zurich, Switzerland, 27/04/2015. 156. Porchet F. Spinale Tumore, chirurgische Behandlungsoptionen. Montagsfortbildung für Ärzte, Schulthess Clinic, Zurich, Switzerland, 14/12/2015. 157. Porchet F and Becker HJ. Décompression et stabilisation dans la chirurgie du rachis. Tessiner Hausarzt-Fortbildung, Bellinzona, Switzerland, 22/09/2015. 158. Porchet F and Onofrio E. Evaluation of surgical treatment of cervical radiculopathy after arthroplasty, WFNS experience. 31st Annual Meeting of the Section of Disorders of the Spine and Peripheral Nerves. Spine Summit, Phoenix, USA, 04 – 07/03/2015. 159. Preiss S. Early experience Attune. Attune Meeting London, London, UK, 17/03/2015. 160. Preiss S. Erste Erfahrungen mit Persona. Masterclass Persona, Berlin, Germany, 11/06/2015. 161. Preiss S. Kombination von Osteotomie und Teilprothese. 12. Kniekurs Hannover, Hannover, Deutschland, 29. – 30.05.2015. 162. Preiss S. Live-OP: Unikondylärer Gelenkersatz (DePuy Synthes SIGMA HP Partial Knee). 12.  Kniekurs Hannover, Hanover, Germany, 29 – 30/05/2015.

163. Preiss S. Unikondylärer Gelenkersatz: Indikation, Technik und Ergebnisse. 12. Kniekurs Hannover, Hanover, Germany, 29 – 30/05/2015.

179. Salzmann GM. Langzeitergebnisse nach ACT. 32. Kongress der Gesellschaft für Arthroskopie und Gelenkchirurgie (AGA), Dresden, Germany, 17 – 19/09/2015.

164. Preiss S. Workshop: Demo Instrumentarium ATTUNE Kniesystem, SIGMA HP Partial Knee Uni und Femuropatellarprothese. 12. Kniekurs Hannover, Hanover, Germany, 29 – 30/05/2015.

180. Salzmann GM. Management options for bone marrow oedema, including subchondroplasty. 12 th World Congress of the International Cartilage Repair Society (ICRS), Chicago, USA, 08 – 11/05/2015.

165. Rippstein P. Ankle arthritis and ankle replacement TAA: an overview. 60th National Congress of the Colombian Society of Orthopaedic Surgery and Traumatology (SCCOT), Cartagena, Colombia, 20 – 23/05/2015.

181. Salzmann GM. OA in soccer. National Symposium on Knee Osteoarthritis, Lausanne, Switzerland, 18/06/2015.

166. Rippstein P. Ankle replacement versus ankle fusion. 60th National Congress of the Colombian Society of Orthopaedic Surgery and Traumatology (SCCOT), Cartagena, Colombia, 20 – 23/05/2015. 167. Rippstein P. Combination of 1 MTP fusion and proximal correction for massive bunion deformities with increased IM angle. 60th National Congress of the Colombian Society of Orthopaedic Surgery and Traumatology (SCCOT), Cartagena, Colombia, 20 – 23/05/2015. 168. Rippstein P. Failed TAA. 60th National Congress of the Colombian Society of Orthopaedic Surgery and Traumatology (SCCOT), Cartagena, Colombia, 20 – 23/05/2015. 169. Rippstein P. The lapidus procedure: technique and pitfalls. 60th National Congress of the Colombian Society of Orthopaedic Surgery and Traumatology (SCCOT), Cartagena, Colombia, 20 – 23/05/2015. 170. Rippstein P. Moderation: tendon ruptures. Swiss Foot and Ankle Society (SFAS) Annual Meeting, Lugano, Switzerland, 08/05/2015. 171. Rippstein P. My personal evolution in bunion surgery. 60th National Congress of the Colombian Society of Orthopaedic Surgery and Traumatology (SCCOT), Cartagena, Colombia, 20 – 23/05/2015. 172. Rippstein P. Painful TAA. 60th National Congress of the Colombian Society of Orthopaedic Surgery and Traumatology (SCCOT), Cartagena, Colombia, 20 – 23/05/2015. 173. Rippstein P. The scarf osteotomy: technique and pitfalls. 60th National Congress of the Colombian Society of Orthopaedic Surgery and Traumatology (SCCOT), Cartagena, Colombia, 20 – 23/05/2015. 174. Rippstein P. Surgical treatment of chronic achillodynia, my strategy. 60th National Congress of the Colombian Society of Orthopaedic Surgery and Traumatology (SCCOT), Cartagena, Colombia, 20 – 23/05/2015. 175. Salzmann GM. Behandlungsverfahren bei Knorpelverletzungen und Nachbehandlung. University Hospital Zurich Fortbildung Physiotherapie Ergotherapie, Zurich, Switzerland, 24/08/2015. 176. Salzmann GM. Current state of the art in surgical cartilage repair. 5th Symposium of the Center for Applied Biotechnology and Molecular Medicine (CABMM), Zurich, Switzerland, 05/11/2015.

182. Salzmann GM. Resultate innovativer Knorpeleingriffe am Kniegelenk. Hausarztfortbildung: Was gibt es Neues in der Kniechirurgie ? Schulthess Clinic, Zurich, Switzerland, 17/09/2015. 183. Schindele S. CapFlex-PIP Oberflächenersatz am PIP-Gelenk. Wiener Handkurse: 7. Rheumahandkurs, Vienna, Austria, 23/04/2015. 184. Schindele S. Endoskopische Dekompression N. medianus mit Centerline. Tipps und Tricks. 49. Jahreskongress der Schweizerischen Gesellschaft für Handchirurgie (SGH) / 17. Jahreskongress der Schweizerischen Gesellschaft für Handrehabilitation (SGHR), Fribourg, Switzerland, 05 – 06/11/2015. 185. Schindele S. Moderation: imaging and nerve. 49. Jahreskongress der Schweizerischen Gesellschaft für Handchirurgie (SGH) / 17. Jahreskongress der Schweizerischen Gesellschaft für Handrehabilitation (SGHR), Fribourg, Switzerland, 05 – 06/11/2015. 186. Schindele S. Moderation: most compelling cases of the year. 49. Jahreskongress der Schweizerischen Gesellschaft für Handchirurgie (SGH) / 17. Jahreskongress der Schweizerischen Gesellschaft für Handrehabilitation (SGHR), Fribourg, Switzerland, 05 – 06/11/2015. 187. Schindele S. Moderation: Varia (M. Dupuytren, Handtherapie, HG Arthroskopie). 13. Kongress Orthopädisch traumatologischer Arbeitskreis Südwest (OTA), Konstanz, Germany, 10 –11/07/2015. 188. Schindele S. Rheumatische Arthritis an Hand und Handgelenk. 13. Kongress Orthopädisch traumatologischer Arbeitskreis Südwest (OTA), Konstanz, Germany, 10 –11/07/2015. 189. Schindele S. Therapiekonzepte bei Arthrosen der Fingergelenke. Fortbildung Pflegepersonal, Schulthess Clinic, Zurich, Switzerland, 05/05/2015. 190. Schindele S. Workshop leader and instructor: Implantation CapFlex-PIP über dorsalen Zugang und palmarer Zugang zum PIP-Gelenk. Wiener Handkurse: 7. Rheumahandkurs, Vienna, Austria, 23/04/2015. 191. Schindele S. Xiapex Training. Xiapex Extension, Schulthess Clinic, Zurich, Switzerland, 26/10/2015. 192. Schwyzer HK. Complications with metal back glenoids. Arthrex Arthroplasty Faculty Forum, Naples, USA, 01 – 02/05/2015.

177. Salzmann GM. “Ist der Meniskus ein Organ ?” oder “Was leistet der Meniskus im Knie ?”. Freiburger Knorpeltage 2015, Freiburg, Germany, 23 – 24/01/2015.

193. Schwyzer HK. Das Leben mit einer anatomischen Schulterprothese: Was kann im Verlauf über 10 Jahre erwartet werden ? Salzburger Schulterforum: Endoprothetik des Schultergelenkes, Salzburg, Austria, 03 – 04/12/2015.

178. Salzmann GM. Knorpelersatzverfahren. Aarau Cantonal Hospital Fortbildung Knorpelersatzverfahren, Aarau, Switzerland, 13/08/2016.

194. Schwyzer HK. Der Golfer und seine Schulter – medizinische Probleme der Schultergelenke im Golfsport. Golf und die Schulter, Schulthess Clinic, Zurich, Switzerland, 26/10/2015.

A maximum of ten lectures / advanced training courses per person are included in the list of publications.

136

195. Schwyzer HK. Die infizierte Schulterprothese: Management und Resultate. Salzburger Schulterforum: Endoprothetik des Schultergelenkes, Salzburg, Austria, 03 – 04/12/2015.

4.

Pochon L. Influence of gender on patient-oriented outcomes in spine surgery (Master of Medicine). Zurich, Switzerland: University of Zurich, 2015. Supervisor: Mannion AF.

196. Schwyzer HK. Gibt es eine Altersgrenze für die anatomische Prothese ? 14. Bogenhausener Schultersymposium, Munich, Germany, 20 – 21/11/2015.

5.

Rieser M. The effectiveness of neuromuscular training of the lower limb muscles in reducing the hip symptoms in patients with symptomatic femoroacetabular impingement: a pilot study (Master of Science Health Sciences and Technology). Zurich, Switzerland: Swiss Federal Institute of Technology (ETH) Zurich, 2015. Supervisors: Casartelli NC and Maffiuletti NA.

6.

Visscher R. Reliability and validity of an instrumented treadmill: an observational study in patients with knee osteoarthritis (Bachelor of Science Human Movement Science). Groningen, Netherlands: University of Groningen, 2015. Supervisors: Hortobagyi T and Maffiuletti NA.

197. Schwyzer HK. Inverse Prothetik – Univers Revers 2-Jahres-Ergebnisse. Schulter-Update, Kitzbühel, Austria, 19 – 20/06/2015. 198. Schwyzer HK. Obere Extremitätenverletzungen beim Sport. 24. Zürcher Schmerzkonferenz, Zurich, Switzerland, 29/10/2015. 199. Schwyzer HK. Stemless versus stemmed prosthesis in osteoarthritis – midterm results. Contemporary Challenges in Shoulder Surgery, Rome, Italy, 03 – 04/07/2015. 200. Schwyzer HK. Therapie und Ergebnisse bei langer Bizepssehne & Pulley-Läsionen. Schulter-Update, Kitzbühel, Austria, 19 – 20/06/2015. 201. Schwyzer HK. Overview presentation: Entwicklungen und Trends in der inversen Schulterprothetik – Was hat sich bewährt ? 22. Jahreskongress der Deutschen Vereinigung für Schulter- und Ellenbogenchirurgie (DVSE), Mannheim, Germany, 25 – 27/06/2015. 202. Sonderegger M and Vital-Schmid S. Workshop: Praktische Rehabilitation nach Knorpelrekonstruktion. 7. Schulter Tagung, Bern, Switzerland, 02 – 03/07/2015. 203. Thoma A. Osteoporose. Publikumsveranstaltung, Schulthess Clinic, Zurich, Switzerland, 24/03/2015. 204. Vital-Schmid S. Rehabilitation nach Knorpelrekonstruktion. 7. Schulter Tagung, Bern, Switzerland, 02 – 03/07/2015. 205. Willi-Dähn S. Morbus Perthes. Kinderorthopädie für die Praxis, Kinderärzte Schweiz, Schulthess Clinic, Zurich, Switzerland, 29/01/2015. 206. Wirth B. Schultereckgelenk. Eine praxisnahe Fortbildung über Schulter- und Ellbogenverletzung, Schulthess Clinic, Zurich, Switzerland, 18/06/2015.

Other 1.

Schindele S. Von den Fingerspitzen bis zur Handwurzel. Handchirurg Stephan Schindele entspannt Schnappfinger und schneidet Carpal-Tunnel auf. Basler Zeitung (BaZ) 173: 20, 2015.

Dissertations, theses 1.

Huber R. Knee extensor and flexor muscle strength following anterior cruciate ligament reconstruction: influence of graft type (Master of Science Health Sciences and Technology). Zurich, Switzerland: Swiss Federal Institute of Technology (ETH) Zurich, 2015. Supervisor: Maffiuletti NA.

2.

Marti C. Psychometric properties of the EuroQoL EQ-5D to assess quality of life in patients undergoing carpal tunnel release surgery (Master of Science Physical Therapy). Zurich, Switzerland: Zurich University of Applied Sciences (ZHAW), 2015. Supervisor: Marks M.

3.

Naal FD. Patientenorientierte Outcome-Messung in der Orthopädischen Chirurgie (postdoctoral thesis). Munich, Germany: Technical University of Munich (TUM), 2015. Supervisor: Von Eisenhart-Rothe R.

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Project management: Simone Marquart Concept, design, typography and pre-press: Schaffner & Conzelmann AG, Basel Photographs and illustrations: Descience, Lucerne and Schaffner & Conzelmann AG, Basel Departmental report images: Schulthess Clinic photographic documentation Schaffner &Conzelmann AG, Basel In this publication, masculine forms have sometimes been used for the sake of simplicity. In such cases, the feminine form is obviously implied, too. © Wilhelm Schulthess-Stiftung 2016 19008.0516.6500

Schulthess Clinic 2015 in brief Founded in 1883 Converted into a non-profit foundation in 1935 More than 1130 members of staff (816 full-time positions) 160 beds Open to patients with general or supplementary health insurance Turnover CHF 180 million 20600 interventions More than 8900 surgical interventions Consultants' hospital with a range of teaching responsibilities

Schulthess Clinic Lengghalde 2 8008 Zurich, Switzerland Tel. +41 44 385 71 71 Fax +41 44 385 75 38 www.schulthess-klinik.ch