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C Flamme

Publications and source records attributed to C Flamme.

4 recordsLinked to original sources

Follow-up costs up to 5 years after conventional treatments in patients with cartilage lesions of the knee.

In this retrospective cross-sectional study, we contacted patients who had been diagnosed with (and, if necessary, treated for) knee cartilage defects by arthroscopy at one of seven treatment centres in Germany between 1997 and 2001. In early 2003, patients completed a questionnaire on the health care resources they had used since the time of the arthroscopy. Based on this information, we determined follow-up costs. Data from a total of 1,708 patients were included in the final analysis. Of these, 1,070 were assigned to the initial operation (IO) group (61% men, 49+/-15 years; 39% women, 52+/-14 years) and 638 were assigned to the re-operation (RO) group (64% men, 44+/-13 years; 36% women, 47+/-14 years). The cumulative direct medical costs caused by knee complaints for the first 5 years following the arthroscopy were 1,984 Euro for the IO population and 4,203 Euro for the RO population. The cumulative indirect costs (i.e. costs associated with loss of productivity), however, amounted to 7,669 Euro and 15,265 Euro, respectively, and were thus almost four times as high as the cumulative direct costs. This is the first study that quantifies the considerable follow-up costs in patients who have undergone surgery for knee cartilage defects. As such, it may provide a yardstick for future treatments.

Adult↗

[Hindfoot arthrodesis].

Arthrodesis of the hindfoot is indicated in congenital foot deformity of young adults, in posttraumatic arthrosis of the subtalar joint following calcaneus fractures, in idiopathic, isolated arthroses of hindfoot joints, in rheumatoid arthritis and in deformities of the longitudinal arch of the foot. Common and useful combinations are the triple-arthrodesis and the arthrodesis of the subtalar and the calcaneocuboid joint, in particular if both joints are affected by calcaneus fractures. Arthrodesis of the subtalar and the talonavicular joint are often performed as isolated procedures. The three-dimensional structure of the hindfoot articulations may impede perfect contact of the bone surfaces in combined arthrodeses. Various fixation methods are in use. Follow-up examination of 52 arthrodeses after 11.1 years revealed good, symptomatic improvement in most patients. However, complete bony union was achieved in only 47 percent, and this was due to insufficient stabilization of the arthrodesis in many cases. In view of comparable rates of pseudarthroses in the literature, we advocate stable internal fixation with screws or bone staples.

Activities of Daily Living↗