Klinger, Hans-Michael

[["dc.bibliographiccitation.firstpage","96"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","Knee Surgery Sports Traumatology Arthroscopy"],["dc.bibliographiccitation.lastpage","112"],["dc.bibliographiccitation.volume","21"],["dc.contributor.author","Spahn, Gunter"],["dc.contributor.author","Hofmann, Gunther O."],["dc.contributor.author","von Engelhardt, Lars Victor"],["dc.contributor.author","Li, Mengxia"],["dc.contributor.author","Neubauer, Henning"],["dc.contributor.author","Klinger, Hans Michael"],["dc.date.accessioned","2018-11-07T09:30:48Z"],["dc.date.available","2018-11-07T09:30:48Z"],["dc.date.issued","2013"],["dc.description.abstract","Both high tibial valgus osteotomy (HTO) and unicompartmental medial knee arthroplasty (UKA) are established methods for the treatment for moderate stages of OA. This is the first global meta-analysis to compare the long-term effects of both methods regarding survival, outcomes and complications of total arthroplasty. Literature research was performed using established medical databases: MEDLINE (via PubMed), EMBASE (via OVID) and the Cochrane register. Criteria for inclusion were as follows: English or German papers, a clinical trial with a clear description of survival, an outcome evaluation using a well-described knee score and a follow-up > 5 years. Statistical analysis was performed using the special meta-analysis software called \"Comprehensive Meta Analysis\" (version 2.0; Biostat, Englewood, NJ, USA). Final meta-analysis after the full-text review included 46 studies about valgus HTO and 43 studies about medial UKA. There were no significant differences between valgus HTO and medial UKA in terms of the number of total required replacements. After a 5- to 8-year follow-up, 91.0% of the valgus HTO patients and 91.5% of medial UKA patients did not need a total replacement. This value was 84.4% for valgus HTOs and 86.9% for medial UKAs after a 9- to 12-year follow-up. Mean survival time to TKA was 9.7 years after valgus HTO and 9.2 years after medial UKA. Clinical outcome was significantly better after medial UKA in a 5- to 12-year follow-up. After more than 12 years, results were comparable in both groups. No significant differences were seen in the complication rates. This meta-analysis aimed to find the advantages and disadvantages of two established methods for the treatment for medial compartment knee osteoarthritis. Valgus HTO is more appropriate for younger patients who accept a slight decrease in their physical activity. Medial UKA is appropriate for older patients obtaining sufficient pain relief but with reduced physical activity. II."],["dc.identifier.doi","10.1007/s00167-011-1751-2"],["dc.identifier.isi","000313047100012"],["dc.identifier.pmid","22076053"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/31395"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Springer"],["dc.relation.issn","0942-2056"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.title","The impact of a high tibial valgus osteotomy and unicondylar medial arthroplasty on the treatment for knee osteoarthritis: a meta-analysis"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","2516"],["dc.bibliographiccitation.issue","12"],["dc.bibliographiccitation.journal","The American Journal of Sports Medicine"],["dc.bibliographiccitation.lastpage","2521"],["dc.bibliographiccitation.volume","38"],["dc.contributor.author","Spahn, G."],["dc.contributor.author","Klinger, H. M."],["dc.contributor.author","Baums, M."],["dc.contributor.author","Hoffmann, M."],["dc.contributor.author","Plettenberg, H."],["dc.contributor.author","Kroker, A."],["dc.contributor.author","Hofmann, Gunther O."],["dc.date.accessioned","2019-07-09T11:52:57Z"],["dc.date.available","2019-07-09T11:52:57Z"],["dc.date.issued","2010"],["dc.description.abstract","Background: Mechanical tests to grade cartilage damage are limited by the instruments used and by the ability to access all areas of cartilage within a joint. Better methods to diagnose cartilage injury or degeneration are needed. Purpose/Hypothesis: To detect the interobserver variance of arthroscopic cartilage grading by subjective judgment using the International Cartilage Repair Society (ICRS) score and by objective measurement using near-infrared (NIR) spectroscopy. We hypothesized that objective measurement of cartilage lesions by NIR spectroscopy will yield more valid results than routine grading using the ICRS score. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Fifteen patients undergoing arthroscopic knee operations were evaluated by 4 experienced arthroscopists independently. The cartilage lesions within the medial knee compartment were estimated by each observer using the ICRS grade and by measurements with a special arthroscopic NIR spectroscopy probe. Results: The ICRS grading had a poor interobserver agreement, with a mean Fleiss kappa index of k = 0.173. Only in 10% (6 of 60) of judged cartilage areas did all 4 surgeons grade the cartilage areas with the same result. In 17 areas (28.3%), the surgeons had a variance of 2 or more grades. In the remaining cases, the surgeons varied within 1 grade. The objective NIR spectroscopyobtained measurements of cartilage resulted in a significant correlation within the observers of R = 0.885 6 0.036 (P\\.001). Conclusion: Our results of interobserver evaluation in real-time arthroscopic cartilage grading suggest that this subjective grading is not satisfactory. This study emphasizes the need for objective measurement techniques for arthroscopic cartilage grading. Near-infrared spectroscopy has a good interobserver correlation. Thus, this method could be developed in the future as a precise method of measuring cartilage lesions."],["dc.identifier.doi","10.1177/0363546510376744"],["dc.identifier.fs","577162"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/6179"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/60305"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.subject.ddc","610"],["dc.title","Near-Infrared Spectroscopy for Arthroscopic Evaluation of Cartilage Lesions: Results of a Blinded, Prospective, Interobserver Study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","47"],["dc.bibliographiccitation.journal","BMC Musculoskeletal Disorders"],["dc.bibliographiccitation.volume","8"],["dc.contributor.author","Spahn, Gunter"],["dc.contributor.author","Plettenberg, Holger"],["dc.contributor.author","Kahl, Enrico"],["dc.contributor.author","Klinger, Hans-Michael"],["dc.contributor.author","Mueckley, Thomas"],["dc.contributor.author","Hofmann, Gunther O."],["dc.date.accessioned","2018-11-07T11:02:19Z"],["dc.date.available","2018-11-07T11:02:19Z"],["dc.date.issued","2007"],["dc.description.abstract","Background: Arthroscopy is a highly sensitive method of evaluating high-grade cartilage lesions but the detection of low-grade lesions is often is unreliable. Objective measurements are required. A novel NIRS (near-infrared-spectroscopy) device for detection of low-grade cartilage defects was evaluated in a preliminary clinical study. Methods: In 12 patients who had undergone arthroscopy, the cartilage lesions within the medial knee compartment were classified according to the ICRS protocol. With a NIR spectrometer system and an optical probe, similar in design to a hook used for routine arthroscopy, the optical properties of cartilage were measured during arthroscopy. Results: The mean ratio of 2 NIR absorption bands of intact cartilage 3.8 ( range 2.3 to 8.7). was significantly lower than that of cartilage with grade 1 lesions (12.8, range 4.8 to 19.6) and grade 2 lesions (13.4, range 10.4 to 15.4). No differences were observed between grade 1 and grade 2 lesions. Conclusion: NIRS can be used to distinguish between ICRS grade 1 lesions and healthy cartilage during arthroscopic surgeries. The results of this clinical study demonstrate the potential of NIRS to objectify classical arthroscopic grading systems."],["dc.identifier.doi","10.1186/1471-2474-8-47"],["dc.identifier.isi","000247695300001"],["dc.identifier.pmid","17535439"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?goescholar/1255"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/51356"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Biomed Central Ltd"],["dc.relation.issn","1471-2474"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.title","Near-infrared (NIR) spectroscopy. A new method for arthroscopic evaluation of low grade degenerated cartilage lesions. Results of a pilot study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","377"],["dc.bibliographiccitation.issue","3"],["dc.bibliographiccitation.journal","Archives of Orthopaedic and Trauma Surgery"],["dc.bibliographiccitation.lastpage","381"],["dc.bibliographiccitation.volume","131"],["dc.contributor.author","Spahn, Gunter"],["dc.contributor.author","Klinger, Hans Michael"],["dc.contributor.author","Baums, Mike"],["dc.contributor.author","Pinkepank, Ulrich"],["dc.contributor.author","Hofmann, Gunther O."],["dc.date.accessioned","2018-11-07T08:58:54Z"],["dc.date.available","2018-11-07T08:58:54Z"],["dc.date.issued","2011"],["dc.description.abstract","Arthroscopy is a well-established method for grading cartilage lesions. This study was undertaken to evaluate the inter-observer variance of grading cartilage lesions in a real life operation. Four experienced arthroscopic surgeons used diagnostic arthroscopy, one after the other, to grade cartilage lesions in a total of 16 patients who had undergone knee arthroscopy. In summary, a total of 14 cartilage areas in 16 patients were graded (n = 224). The Cohens (Fleiss) Kappa Index for multiple investigators was kappa = 0.052 in the medial, kappa = 0.300 in the central, and kappa = 0.107 in the lateral surface of the patella. The indices were kappa = 0.292 in the medial, kappa = 0.0.255 in the central, and kappa = 0.234 in the lateral surface of the trochlea. The inter-observer variance was kappa = 0.193 in the MFC mean bearing zone, kappa = 0.116 in the margin of the MFC, kappa = 0.168 in the mean bearing zone of the TM, and kappa = 0.164 in the TM margin. In the lateral compartment, the kappa-Index was 0.309 in the LFC mean bearing zone, 0.111 in the margin of the LFC, 0.020 in the mean bearing zone of the TL, and 0.085 in the TL margin. The inter-observer reliability of the arthroscopic grading of cartilage lesions is poor. The major problem is the relatively large variability in differentiating between intact cartilage and lesions that consist of the softening of the cartilage and the differentiation between superficial and deep cartilage lesions. In the future, objective measurements should be developed to solve this problem."],["dc.identifier.doi","10.1007/s00402-011-1259-8"],["dc.identifier.isi","000287450700015"],["dc.identifier.pmid","21249375"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/8064"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/23759"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Springer"],["dc.relation.issn","0936-8051"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.title","Reliability in arthroscopic grading of cartilage lesions: results of a prospective blinded study for evaluation of inter-observer reliability"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","1117"],["dc.bibliographiccitation.issue","8"],["dc.bibliographiccitation.journal","Archives of Orthopaedic and Trauma Surgery"],["dc.bibliographiccitation.lastpage","1121"],["dc.bibliographiccitation.volume","129"],["dc.contributor.author","Spahn, Gunter"],["dc.contributor.author","Klinger, Hans-Michael"],["dc.contributor.author","Hofmann, Gunther O."],["dc.date.accessioned","2018-11-07T11:25:51Z"],["dc.date.available","2018-11-07T11:25:51Z"],["dc.date.issued","2009"],["dc.description.abstract","In general, arthroscopy is considered the \"gold standard\" for the evaluation of cartilage lesions. In this multicenter survey, we ascertained the general opinion of surgeons regarding arthroscopic cartilage diagnoses. A total of 301 highly experienced arthroscopists (instructors of the AGA, the German-speaking society of arthroscopy) were contacted in writing with a request to complete the survey. The data from 105 respondents (34.8% of those contacted) were used for the investigation. In the grading of the cartilage lesions, the Outerbridge classification was most frequently used (n = 87), followed by the ICRS protocol (n = 8) and the Insall score (n = 3). The majority (61%) of the arthroscopic surgeons felt that differentiation between healthy cartilage and low-grade cartilage lesions was simple. For differentiation between grade I and grade II lesions, and for differentiation between grade II and grade III lesions, 41.9 and 51.4%, respectively, thought that there was a \"need for improvement\". In the case of grade IV lesions, 70.5% of the surgeons thought that the diagnosis was valid. The respondents also judged the utility of incorporating objective measurements (e.g., intraoperative biomechanical tests): 13.3% (n = 14) responded that such measurements would be \"very useful\" and 61.9% (n = 65) responded that they would be \"somewhat useful\". Among surgeons, arthroscopy was not perceived to be as reliable as a \"gold standard\" for the diagnosis of cartilage lesions. The majority of experienced arthroscopists felt unsure of the results in general, or at least in some cases. A universal and definitive grading system for lesions appears to be needed. For questionable cases, measurement devices are needed for objective cartilage grading."],["dc.identifier.doi","10.1007/s00402-009-0868-y"],["dc.identifier.isi","000267390000018"],["dc.identifier.pmid","19367409"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/6728"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/56720"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Springer"],["dc.relation.issn","0936-8051"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.title","How valid is the arthroscopic diagnosis of cartilage lesions? Results of an opinion survey among highly experienced arthroscopic surgeons"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]