CLINIC AND O U TPATIE NT CLINIC FO R O R TH O PAE D ICS AND

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1 CLINIC AND O U TPATIE NT CLINIC FO R O R TH O PAE D ICS AND O R TH O PAE D IC S U R GE R Y

FACTS AND FIGURES Clinic and Outpatie nt Clinic for Orth opae dics and Orth opae dic Surge ry Fe rninand- Saue rbruch - Straße 17475 Gre ifs w ald Te le ph one : 03834-867051 Te le fax: 03834-867200

2 FACTS AND FIGURES Clinic and Outpatie nt Clinic for Orth opae dics and Orth opae dic Surge ry Fe rninand- Saue rbruch - Straße Gre ifs w ald Te le ph one : Te le fax: E- m ail: orth o@ uni- gre ifs w ald.de H om e page : w w w.m e dizin.uni- gre ifs w ald.de /orth o/ H e ad of de partm e nt: Se nior ph ys icians : Univ.- Prof. D r. m e d. H. M e rk D r. m e d. U. Sch ie ts ch, h e ad of s e nior ph ys icians (h e ad of h ip joint s urge ry) As s ociate profe s s or D r. m e d. N. Fo lak, de puty h e ad (h e ad of food, ank le joint and s h oulde r s urge ry) As s ociate profe s s or OA PD D r. m e d. A. Lah m, e xe cutive s e nior ph ys ician (h e ad of pae diatric, ne uroorth opae dics, s port orth opae dics ) OA D r. m e d. T. Barz (h e ad of Spine Ce ntre ) OA D r. m e d. H. Fraue ndorf (h e ad of outpatie nt clinic) OA. D r. m e d. F.G. Sm is ze k (h e ad of tum our s urge ry) OA D r. m e d H. Spank (h e ad of k ne e joint s urge ry) OA D r. m e d. A. Z ach (h e ad of H and Ce ntre ) H e ad of nurs ing s taff: QM re pre s e ntative : Frau I. Bie ble r Ge s ch äfts füh re nde r OA PD D r. m e d. A. Lah m Th e Clinic and Outpatie nt Clinic for Orth opae dics and Orth opae dic Surge ry h as 62 be ds. In th e ye ar of th e re port 2006 th e clinic tre ate d 2075 inpatie nts and 4231 outpatie nts. QUALITY REPORT FOR PATIENTS 2006 UNIVERSITY CLINIC GREIFSW ALD

3 T M ED ICAL CARE SERVICES h e Clinic and Outpatie nt Clinic for Orth opae dics and Orth opae dic Surge ry h as w ith its h e ad Prof. D r. H. M e rk 19 doctors and is th us able to provide th e m axim um range of ope rative and non- ope rative th e rapie s on th e fie ld of orth opae dics and orth opae dic s urge ry. W e are able to pe rform th e com ple te range of ope rations to tre at dis e as e s of th e locom otor s ys te m. Th e s e include th e im plantations of e ndopros th e s e s to h ip, k ne e, s h oulde r, e lbow, toe and ank le joints, w ris ts and finge r joints. In a ye ar m ore th an 4000 patie nts re ce ive tre atm e nt in th e orth opae dic outpatie nt de partm e nt w ith in th e s cope of e m e rge ncy, afte r- care or outpatie nt tre atm e nt. M ore ove r, th e clinic offe rs various s pe cialis e d cons ultation h ours. M ore th an 2000 ope rations are pe rform e d for e m e rge ncie s and e le ctive ope rations. For th is w e h ave 3 ope ration th e atre s and additionalope ration capacitie s on th re e w ards w ith 62 be ds available. Additionalbe ds on th e inte ns ive care units and for pae diatric orth opae dics are available. Eve ry ye ar m ore th an 2000 patie nts re ce ive inpatie nt tre atm e nt. Th e ch air of orth opae dics and orth opae dic s urge ry w as founde d is th us one of th e olde s t ch airs on th is fie ld in th e north of Ge rm any. Th e clinic is able to pe rform th e w h ole range of orth opae dic proce dure s on th e h igh e s t pos s ible le ve l. Th e h e ad of th e de partm e nt Prof. D r. H arry M e rk is a m e m be r of th e board of th e de partm e nt Spine and of th e w ork ing group Navigation w ith in th e w ork ing circle Navigation and com pute r- contro le d Surge ry of th e Ge rm an Socie ty for Orth opae dics and Orth opae dic Surge ry (D e uts ch e Ge s e ls ch aft for Orth opädie und Orth opädis ch e Ch irurgie D GOOC). M ore ove r, Prof. D r. M e rk is vice pre s ide nt of th e Inte rnational Socie ty for M ole cular Orth opae dics. As a ce ntre of m axim um m e dicalcare on a s uprare gionalle ve lth e Clinic for Orth opae dics and Orth opae dic s urge ry tre ats patie nts w ith de ge ne rative dis e as e s of th e w h ole locom otor s ys te m according to up- to- date s tandards and w ith im plants of th e ne w e s t ge ne ration. UNIVERSITY CLINIC GREIFSW ALD QUALITY REPORT FOR PATIENTS 2006

4 Th e Clinic for Orth opae dics pe rform s e ve ry arth ros copic proce dure to k ne e, s h oulde r, ank le and e lbow joints and w ris ts. Our s tandard proce dure s include up- to- date te ch niq ue s to tre at dis e as e s of m e nis ci and cartilage s, th e ne w e s t te ch niq ue s to re cons truct th e cruciate k ne e ligam e nt as w e las arth ros copic s tabilis ing proce dure s and th e re cons truction of th e rotator cuff of th e s h oulde r. S SPECIAL AREAS OF M ED ICAL CARE pe cialitie s are th e tre atm e nt of dis e as e s affe cting th e s pine, th e h ip and k ne e joints, foot s urge ry and th e s pe cialtre atm e nt of ch ildre n. Th e co- ope ration be tw e e n th e Clinic for Orth opae dics and th e D e partm e nt of Em e rge ncy Surge ry e nable s doctors to be furth e r traine d to be a s pe cialis t for orth opae dics and e m e rge ncy s urge ry. Prof. D r. M e rk is furth e r auth oris e d to train doctors on th e fie ld of rh e um atology and on th e fie ld of ph ys icaland re h abilitative m e dicine. Th e clinic s de partm e nt of s port orth opae dics h as an e xce le nt re putation w ith in Ge rm any. Profe s s ionaland non- profe s s ionalath le te s from th e w h ole of Ge rm any and from abroad are re fe rre d to our clinic and are tre ate d h e re. Th e Clinic for Orth opae dics is als o s pe cialis e d on th e tre atm e nt of ch ildre n. In coope ration w ith th e pae diatric clinic injurie s and dis e as e s affe cting our little patie nts are optim a ly tre ate d. W e h ave cons ultation h ours s pe cialis e d on pae diatric orth opae dics for long- te rm care and pos t- ope rative care. Oth e r focus e s of th e de partm e nt are foot orth opae dics, rh e um atis m orth opae dics and th e tre atm e nt of tum ours of th e locom otor s ys te m. Th e h e ad of th e foot orth opae dics de partm e nt, Prof. D r. N. Fo lak, is als o w ork ing as an ins tructor for th e Ge rm an as s ociation of ank le joints. Th e Clinic for Orth opae dics h as an ow n re s e arch de partm e nt w ith a ce lculture laboratory. Th is m ak e s s urge ry w ith culture d cartilage s (tis s ue e ngine e ring), als o in com bination w ith m e nis cus trans plantation, pos s ible. W e can look back on s e ve ral ye ars of e xpe rie nce in th is ne w form of s urge ry. And com bine d w ith optim is e d QUALITY REPORT FOR PATIENTS 2006 UNIVERSITY CLINIC GREIFSW ALD

5 s urge ry and afte r care m e th ods w e are able to guarante e th e be s t pos s ible th e rape utic re s ults. In cas e s, in w h ich arth roplas ty is not pos s ible, m ode rn artificialjoint de vice s can be im plante d in th e s h oulde r, th e e lbow, th e k ne e and in th e ank le w ith th e h e lp of com pute r navigation s ys te m s. Als o in th e s e cas e s it be com e s m ore and m ore im portant to us e e xpe rie nce s gaine d from e m e rge ncy tre atm e nt in th e traum atology de partm e nt and from th e tre atm e nt of de ge ne rative joint dis e as e s in th e orth opae dics de partm e nt. Be s ide s th e us e w ith com pute r navigation s ys te m s and artificialinte rve rte braldis k de vice s (re gions of lum bar colum n and ce rvicals pine ) m inim alinvas ive te ch niq ue s are als o applie d in s pinals urge ry. Th us, th e proce dure s w h ich are q uite s e ve re as s uch are re duce d to a m inim als train for th e patie nts and th e ris k of occurring com plications is m inim is e d s ignificantly. Th is is als o true of th e innovative k yph oplas tic, applie d in cas e s of os te oporotic fracture s, and th e com ple te ly e ndos copic re vis ion of inte rve rte braldis k s. Kyph oplas tic m e ans th ata co laps e d ve rte bra w h ich h as be e n s traigh te ne d w ith th e h e lp of a ba loon is s tabilis e d w ith a s pe cialk ind of bone ce m e nt. Prof. D r. M e rk is a m e m be r of th e board of th e w ork ing group for e ndopros th e tics. Th e clinic is als o a m e m be r of various inte rnationale xpe rt groups w h ich de ve lop ne w im plants and ope ration te ch niq ue s. It is th us guarante e d th e orth opae dic tre atm e nt in th e clinic in Gre ifs w ald is alw ays up- to- date and th at th e de partm e nt is alw ays able to offe r th e optim alth e rape utic proce dure s. One e xam ple is our m e m be rs h ip in th e re s e arch de partm e nt of th e As s ociation of M us culos k e le talne tw ork s for Biom e ch anics of th e Ge rm an Socie ty for Orth opae dics and Orth opae dic Surge ry (D e uts ch e Ge s e ls ch aft for Orth opädie und Orth opädis ch e Ch irurgie D GOOC) w ith a pe e r re vie w financing of th ird party- funding proje cts. Th e h e ad of th is group is as s ociate profe s s or D r. A. Lah m. W e h ave th e e q uipm e nt for gait analys is and m ove m e nt m e as ure m e nts (proprioce ption), w h ich are available to our patie nts and w h ich are us e d inte ns ive ly for s cie ntific purpos e s. UNIVERSITY CLINIC GREIFSW ALD QUALITY REPORT FOR PATIENTS 2006

Th e de partm e nt s oth e r re s e arch foci include bone and cartilage re s e arch, tis s ue s ubs titution (tis s ue e ngine e ring) for bone - cartilage cons tructs, ge ne ralbiom e ch anical re

6 Th e de partm e nt s oth e r re s e arch foci include bone and cartilage re s e arch, tis s ue s ubs titution (tis s ue e ngine e ring) for bone - cartilage cons tructs, ge ne ralbiom e ch anical re s e arch and th e de ve lopm e nt of ne w im plants. For afte r care tre atm e nt w e h ave a big outpatie nt de partm e nt w h ich offe rs various s pe cialis e d cons ultation h ours. A te am s ys te m e ns ure s th at a patie nt is e xclus ive ly tre ate d by th e s am e te am of doctors during h is w h ole proce s s of tre atm e nt, w h ich range s from th e pre - e xam ination or th e accide nt of th e patie nt ove r th e s tay in h os pitalw ith s urge ry to th e e nd of h is tre atm e nt w ith outpatie nt cons ultations. M EASURES OF INTERNAL QUALITY M ANAGEM ENT H ygie ne > D ocum e ntation of h os pital- borne infe ctions w h ich are e valuate d tw ice a ye ar > Re s is tance s and cons um ption of antibiotics > D aily s cre e ning of a lpos itive re le vant m icrobiologicalfindings for unus ual ge m s, re s is tance s QUALITY REPORT FOR PATIENTS 2006 UNIVERSITY CLINIC GREIFSW ALD

7 M ain diagnos e s according to ICD in 2006 RANKIG ICD NAM E CASES 1 M 16 Coxarth ros is (arth ros is ofh ip) M 17 Gonarth ros is (arth ros is ofk ne e ) M 20 Acq uire d de form itie s of finge rs and toe s T84 Com plications of inte rnalorth opae dic pros th e tic de vice s, im plants and grafts M 54 Dors algia M 75 Sh oulde r le s ions M 9 4 Oth e r dis orde rs ofcartilage M 23 Inte rnalde range m e nt of k ne e M 51 Oth e r inte rve rte braldis c dis orde rs M 19 Oth e r arth ros is 64 Com pe te ncy diagnos e s according to ICD in 2006 ICD M 17.1 M 16.1 NAM E Oth e r prim ary coxarth ros is Oth e r prim ary gonarth ros is T84.0 M e ch anicalcom plication ofinte rnaljoint pros th e s is M 51.1 Lum bar and oth e r inte rve rte braldis c dis orde rs w ith m ye lopath y / radiculopath y T84.5 Infe ction and inflam m atory re action due to inte rnaljointpros th e s is M Spinalins tabilitie s Q65.8 Oth e r conge nitalde form itie s ofh ip M M M D e range m e ntofm e nis cus due to old te ar or injury Oth e r s e condary s colios is Oth e r acq uire d de form itie s ofank le and foot Inform ation s tate d h e re are additionalcom pe te nce s for th e m ain diagnos e s m e ntione d above (inde pe nde nt of th e cas e s tre ate d in th e re port ye ar 2006). UNIVERSITY CLINIC GREIFSW ALD QUALITY REPORT FOR PATIENTS 2006

8 M ain proce dure s according to OPS in 2006* RANKING ICD NAM E CASES Re pe ate d ope rative e xam ination and tre atm e nt afte r joints urge ry Articular cartilage or articular m e nis cus s urge ry of th e k ne e jointth rough an e ndos copy Articular e ndos te um s urge ry th rough an e ndos copy Im plantation ofartificialh ip joint Trans plantation ofbone tis s ue Surge ry to footbone s Im plantation ofartificialk ne e joint Sam pling ofbone tis s ue for im plantation purpos e s Ope rative acce s s to lum bar colum n, s acrum or coccyx Re pe ate d joints urge ry th rough an e ndos copy 181 * Th e s urve i lance of vitals igns during ope rations and anae s th e s ia/s e dations, anae s th e s ia on its ow n and blood trans fus ions during th e proce dure s are not s tate d s e parate ly. Com pe te ncy proce dure s according to OPS in 2006 OPS NAM E Im plantation of artificialh ip joint Im plantation of artificialk ne e joint(bicondylar s urface s ubs titution proth e s is, notlink e d up, w ith out ine rve rte braldis c s ubs titution) Oth e r com ple x re parative proce dure to s pine, e.g. late ralcurvature ofth e s pine : prim ary s table Oth e r s pinalope ration: im plantation ofartificialinte rve rte braldis k Re pe ate d s urge ry, e xch ange or re m ovalofartificialh ip joint: e xch ange ofa non- ce m e nte d artificialjoint Re m ovalof affe cte d inte rve rte braldis k tis s ue : re m ovalofinte rve rtabraldis k, th rough s k in th ough e ndos copy Se ction of bone tis s ue to adjus tm alpos itions : com ple x (m ulti-dim e ns ional) s e ction Re m ovalof k ne e jointm e nis ci th rough an e ndos copy x Oth e r re pe ate d s urge ry, e xch ange or re m ovalofartificialk ne e joint x Oth e r foot bone s urge ry Inform ation s tate d h e re are additionalcom pe te nce s for th e m ain com pe te ncie s m e ntione d above (inde pe nde nt of th e cas e s tre ate d in th e re port ye ar 2006). QUALITY REPORT FOR PATIENTS 2006 UNIVERSITY CLINIC GREIFSW ALD

9 Com paris on of s e le cte d q uality indications 2006 PRE-POPERATIVE STAY IN H OSPITALLONGER TH AN 48 H RS PATIENTS W ITH ANTIBIOTIC PROPH YLAXIS GENERALPOST-OPERTAIVE COM PLICATIONS: EXCH ANGE OF TOTALENDOPROSTH ETIC DEVICE TO KNEE OR OF COM PONENTS A fo low - up e xam ination of 601 intoe corre ction ope rations s h ow e d a s ucce s s rate of 9 1%, i.e. ne e d for re vis ion of 9 %. Com pare d to oth e r inte rnationalre s ults (according to s tudy w ith bigge r groups of patie nts 12-15% ) our re s ults lie far above ave rage. W ith in Ge rm any our s tudie s conce rning bone de ns ity of patie nts w ith artificialk ne e or h ip joints are uniq ue. Th e s ucce s s rate of cartilage - bone trans plantations, m e as ure d on 80 patie nts w ith th e M cd e rm ott- s core, is 9 5%, w h ich lie s w ith in inte rnationaltop rate s (e.g. th e bigge s t s tudy publis h e d by H angody e t al(2001) w ith about 600 patie nts ). UNIVERSITY CLINIC GREIFSW ALD QUALITY REPORT FOR PATIENTS 2006

10 RESEARCH In our re s e arch data bas e you can alw ays find curre nt re s e arch re ports of our clinic: h ttp://fodb.uni- gre ifs w ald.de /inde x.ph p. QUALITY REPORT FOR PATIENTS 2006 UNIVERSITY CLINIC GREIFSW ALD

INS TITU TE O F CLINICAL CH E M IS TR Y AND LABO R ATO R Y

INS TITU TE O F CLINICAL CH E M IS TR Y AND LABO R ATO R Y M E D ICINE FACTS AND FIGURES Ins titute of ClinicalCh e m is try and Laboratory M e dicine Fe rdinand- Saue rbruch - Straße 17475 Gre ifs w ald