Hip dysplasia in young adults - Nasjonalt Register for Leddproteser

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Hip dysplasia in young adults
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6.2.1
A historical overview ................................................................................................................ 19
6.2.2
Normal development of the hip joint ......................................................................................... 22
6.2.3
Definition and terminology ....................................................................................................... 24
6.2.4
Epidemiology ............................................................................................................................ 25
6.2.5
Aetiology ................................................................................................................................... 26
6.2.6
Natural history of hip dysplasia ................................................................................................ 29
6.2.7
Diagnosis in newborns and infants ........................................................................................... 31
6.2.8
Diagnosis in adolescents and adults ......................................................................................... 37
6.2.9
Treatment options ..................................................................................................................... 39
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6.6.1
The 1988-1990 Hip Cohort ....................................................................................................... 47
6.6.2
The 1989 Hip Project ................................................................................................................ 49
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8.1.1
Paper I ...................................................................................................................................... 54
8.1.2
Paper II ..................................................................................................................................... 55
8.1.3
Paper III.................................................................................................................................... 55
8.1.4
Paper IV .................................................................................................................................... 55
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8.2.1
Radiographic parameters associated with hip dysplasia at skeletal maturity .......................... 56
8.2.2
EQ-5D ....................................................................................................................................... 59
8.2.3
WOMAC Osteoarthritis Index ................................................................................................... 60
8.2.4
The Beighton score ................................................................................................................... 60
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Statistical software .................................................................................................................... 64
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Study design .............................................................................................................................. 68
10.1.2
Health registry studies – pros and cons .................................................................................... 71
10.1.3
Quality of register data ............................................................................................................. 73
10.1.4
Patient reported outcome measures .......................................................................................... 76
10.1.5
Reproducibility in measurement studies .................................................................................... 79
10.1.6
Measurement error and measurement uncertainty ................................................................... 80
10.1.7
Defining hip dysplasia at skeletal maturity ............................................................................... 83
10.1.8
Ethics ......................................................................................................................................... 96
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10.2.1
Is the screening programme for hip dysplasia sufficient? ......................................................... 97
10.2.2
Treatment options for hip dysplasia ........................................................................................ 101
10.2.3
Outcome measures in hip dysplasia patients with a THR ....................................................... 103
10.2.4
Repeatability of hip dysplasia measurements.......................................................................... 105
10.2.5
Occurrence of hip dysplasia .................................................................................................... 109
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Figure 4 The stability of the hip examined by Ortolani’s manoeuvre. A positive sign
indicates that a dislocated hip is reduced.
Figure 5 Barlow’s manoeuvre is another test used to examine the stability of the hip. If
the hip can be dislocated by manipulation, the test is positive.
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Figure 6 Six-month-old girl with hip dislocation in the right hip presented with (A) reduced
abduction and (B) a positive heel-buttock test.
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Figure 7 Asymmetric skin folds in a six-month-old girl with hip dislocation in the right hip
(A) and leg length discrepancy illustrated with a positive Galeazzi sign (B).
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a newborn.
B
A
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head
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head
Cartilage
roof triangle
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roof line
Bony rim
Baseline
Alpha angle
Acetabular
roof line
Figure 9 The coronal standard view through the centre of the acetabulum,
showing the bony acetabulum, the bony rim and the cartilage roof triangle (A).
The alpha (Į) and beta (ß) angles are illustrated in B. The baseline passes
through the plane of the ileum. The acetabular roof line runs along the plane of
the bony acetabular convexity and the cartilaginous roof line (inclination line)
passes from the lateral end of the acetabulum to the labrum, parallel to the
cartilaginous roof.
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Table 1 Morphological classification of newborn hips assessed by ultrasound192.
Rosendahl’s modification of Graf’s method92.
Type
Description
Normal
Normal hip. A well-modelled bony acetabular roof with a
sharp lateral edge and a narrow cartilaginous rim.
The alpha angle 60Û
Immature
Adequately formed bony acetabular roof with a rounded
lateral margin and a wide cartilaginous rim, i.e. a
physiological retardation of the acetabular rim.
The alpha angle 50-59ÛÛĮÛ
Dysplastic
Mild: Deficiently formed bony acetabular roof with a
rounded to flattened lateral margin and a wide
cartilaginous rim, i.e. a maturational deficit.
The alpha angle between 43Û and 50ÛÛĮÛ
Corresponds to Graf type IIc
Severe: Poorly formed bony acetabular roof with a
flattened lateral margin and a wide cartilaginous rim.
The alpha angle <43Û
Radiographs
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Table 2 Different classification systems of hip dysplasia at skeletal maturity
Grade
Crowe’s
classification
Severin’s
classification
Hartofilakidis’
classification
I
Less than 50%
subluxation
Normal appearance
Dysplasia
II
50-75% subluxation
Mild deformity
Low dislocation
III
75-100% subluxation
Dysplasia or moderate
deformity of femoral
head/neck or
acetabulum.
High dislocation
Wiberg’s CE
angle>20Û
IV
More than 100%
subluxation
Subluxation
V
False acetabulum
VI
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Figure 10 The Frejka pillow is the standard treatment for newborns with hip dysplasia in
Norway. The pillow is easy to remove and of little strain for the baby.
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Figure 11 Preoperative traction treatment for
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reducible.
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Figure 12 Hip spica cast for a girl with hip dislocation in the right hip.
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Figure 13 Radiograph of a 32-year-old female with a total hip replacement
on the left side due to hip dysplasia.
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Table 3 Different classification systems for hip osteoarthritis
Grade
Tönnis classification
0
No signs of
RVWHRDUWKULWLV
1
Slight narrowing of joint
space, slight lipping at
joint margin, slight
sclerosis of femoral
head or acetabulum
Small cysts in femoral
head or acetabulum,
increased narrowing of
joint space, moderate
loss of sphericity of
femoral head
Large cysts, severe
narrowing or obliteration
of joint space, severe
head, avascular
necrosis
2
3
4
5
Kellgren-Lawrence
classification
No changes of
osteoarthritis
Croft classification
No changes of
osteoarthritis
Possible narrowing of joint
space medially and
possible osteophytes
around femoral head
Osteophytosis only
Definite narrowing of joint
space inferiorly, definite
osteophytes and slight
sclerosis
Joint space narrowing
only
Marked narrowing of joint
space, slight osteophytes,
some sclerosis and cyst
formation and deformity of
femoral head and
acetabulum
Gross loss of joint space
with sclerosis and cysts,
marked deformity of
femoral head and
acetabulum and large
osteophytes.
Two of osteophytosis,
joint space narrowing,
subchondral sclerosis
and cyst formation.
Three of osteophytosis,
joint space narrowing,
subchondral sclerosis,
and cyst formation.
As in grade 4, but with
head
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All born at HUS in the period January 1988-June 1990
1988 + 1990
1989
Study base RCT
(The 1988-1990 Hip Cohort)
Excluded:
- Birth weight <1500 g or severe
disease/malformations (N = 103)
- Declined to participate (N = 5)
Included RCT
(The 1988-1990 Hip Cohort)
N = 11 925
1988
N = 4 739
1989
N = 5 014
1990
N = 2 172
Excluded:
- Normal neonatal hip exam
3 screening groups
Universal
US
Selective
US
Only
clinical
screening
N = 3 613
N = 4 388
N = 3 924
Pathological neonatal hip exam
(clinical and/or US)
N = 569
Study base maturity review (February 2007-March 2009)
(The 1989 Hip Project)
N = 5637
1988 + 1990
N = 569
1989
N = 5 068
Excluded (N = 1 128):
- Not resident in HUS
catchment area*
- emigrated/not found
- dead
Invited to maturity review
N = 4 509
1988 + 1990
N = 503
1989
N = 4 006
Attended maturity review
N = 2 390
1988 + 1990
N = 503
1989
N = 2 081
Excluded after attendance:
- Missing radiographs or
suboptimal quality of
radiographs (N = 9)
- Not born in 1989 (N = 503)
Universal
US
Selective
US
~27%
~33 %
Only
clinical
screening
~40 %
Included for analysis in Paper IV
N = 2 072
Figure 14 Flow of participants in the 1989 Bergen Hip Cohort Study.
HUS: Haukeland University Hospital; US: ultrasound; RCT: Randomised Clinical Trial; N: Number
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Figure 15 Two radiographs were obtained: (A) one erect anteroposterior view and (B) one
supine frog-leg view.
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Figure 16 Clinical examination of the hip: (A) external rotation, (B) internal rotation,
(C) abduction, and (D) extension.
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8.1 DATA
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8.1.1 Paper I
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Norwegian Arthroplasty
Medical Birth Registry
Register (NAR)
of Norway (MBRN)
All total hip replacements
All newborns born after 1967
after 1987
N = 106 716 prostheses
N = 2 218 596 newborns
NAR ļ MBRN
All persons born after 1967 with a primary total
hip replacement (inserted after 1987)
N = 633 prostheses in 442 patients
Figure 17 The two national registries, the Norwegian Arthroplasty Register (NAR)
and the Medical Birth Registry of Norway (MBRN), were linked using the national
personal identification number. In total 442 persons were recorded in both registries.
8.1.2 Paper II
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8.1.3 Paper III
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8.1.4 Paper IV
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8.2 OUTCOME MEASURES
8.2.1 Radiographic parameters associated with hip dysplasia at
skeletal maturity
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Figure 18 The acetabular anatomy is assessed by Sharp's angle, the acetabular roof angle of Tönnis (AA)
and the acetabular depth-width ratio (ADR).
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Figure 19 The position of the femoral head relative to the acetabular cavity is defined using Wiberg's
Centre-Edge (CE) angle, a modification of this (Ogata's angle) and the femoral head extrusion index
FHEI .
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Maximum width teardrop
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Figure 20 The joint space width (JSW) was measured in three places; medial, middle and lateral. Other
measurements are the maximum width of the teardrop and the articulo-trochanteric distance (ATD).
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8.2.3 WOMAC Osteoarthritis Index
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8.2.4 The Beighton score
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Figure 21 The Beighton test assesses joint hypermobility: 1) touching the floor with the
palms of the hands with the knees straight, 2) hyperextension of the knees, 3)
hyperextension of the elbows, 4) touching the forearm with the thump, and 5)
dorsalflexion of the fifth finger more than 90 degrees.
8.3 DIGITAL MEASUREMENT PROGRAMME
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Table 4 Strengths and weaknesses of EQ-5D and WOMAC.
EuroQol EQ-5D
WOMAC
Categories
5 levels:
mobility, self-care, usual activities,
pain and anxiety/depression
24 questions:
pain (5), stiffness (2), physical
function (17)
Score
- 0.594 (worst) to 1 (best).
0 (EHVW) to (ZRUVW)
0 (death)
Strengths
Valid
Reliable
Easy to use
Cost-effective
Valid
Reliable
Limitations
Complex calculation needed
High ceiling effect
Less sensitive
Influenced by factors other
than of lower extremities.
Statistician needed
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10.2.1 Is the screening programme for hip dysplasia sufficient?
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25-88
18-19
40-75
Urograms
General population
Hip pain and/or hip motion
limitation
>45
95 radiographs
3 observers
51 hips
2 observers
30 radiographs
2 observers
51 radiographs
2 observers
39 radiographs
2 observers
36 radiographs
3 observers
30 radiographs
0.61
0.45
0.63
0.73-0-89
25-88
18-40
“Normal” population
18-19
40-75
General population
Hip pain and/or hip motion
limitation
0.83
0.89
0.63
0.83
0.86
0.84
0.75
0.70-0.79
0.90
18-57
0.86-0.89
AA
16-54
0.70-0.82
Sharp’s
angle
18-89
N/A
Age
group
(years)
16-32
0.80-0.95
0.84-0.90
0.78-0.92
0.50-0.92
Normal hips of patients with CLP
in the contralateral hip
Routine control, no hip/lumbar
pain
Patients from orthopaedic
outpatient clinic
Femoroacetabular impingement,
mild hip dysplasia
urograms
Unilateral hip dysplasia
100 radiographs
3 observers
39-136 hips
Nelitz et al.
1999
246
Wiig et al.
2002
148
Lequesne et al.
2004
215
Tannast et al.
2008
155
Mast et al.
2011
145
Lee et al.
2011
210
Stubbs et al.
2011
Engesæter et al.70
2012
38
Bouttier et al.
2012
166
Diagnosis
N radiographs
N observers
Authors
Year
0.83-0.89
0.91-0.93
0.78-0.90
0.72-0.80
0.81-0.92
0.77
0.84
0.65-0.69
ADR
0.84
0.91
0.82
0.67
0.70-0.83
0.73
0.92
0.90
0.25-0.72
0.88-0.92
Wiberg’s
CE angle
0.84-0.97
0.94-0.96
0.77-0.94
0.69-0.84
0.76
0.86-0.97
18-57
0.97-0.98
0.93-0.98
0.85-0.96
0.88-0.92
Wiberg’s
CE angle
0.90
0.88-0.95
0.65-0.69
ADR
17-90
0.55-0.84
0.74-0.89
16-54
0.91-0.94
0.86-0.89
AA
0.90-0.97
0.42-0.85
0.70-0.82
Sharp’s
angle
3-36
months
18-89
Age
group
(years)
16-32
Table 6 Inter-observer variation reported in the literature
36 radiographs
3 observers
95 radiographs
3 observers
51 hips
2 observers
Routine control, no hip/lumbar
pain
Patients from orthopaedic
outpatient clinic
Hip contusion or routine health
check
Femoroacetabular impingement,
mild hip dysplasia
Normal or osteoarthritis
Hip dysplasia
Unilateral hip dysplasia
100 radiographs
3 observers
30 radiographs
2 observers
30 radiographs
2 observers
51 radiographs
2 observers
50 radiorgaphs
1 observer
39 radiographs
2 observers
25 radiographs
2 observers
Nelitz et al.
1999
Tan et al.214
2001
148
Lequesne et al.
2004
215
Tannast et al.
2008
111
Im et al.
2009
155
Mast et al.
2010
McWilliams et
al.157
2010
145
Lee et al.
2011
70
Engesæter et al.
2011
38
Bouttier et al
2012
166
Diagnosis
N radiographs
N observers
Authors
Year
Table 5 Intra-observer variation reported in the literature
0.82
0.84
0.90
0.91
0.65-0.90
0.73-0.87
FHEI
0.79-0.95
0.88-0.93
0.80-0.96
0.94-0.97
0.73-0.87
FHEI
0.98
0.95
0.78-0.92
ATD
0.95-0.99
0.93-0.97
ATD
0.55-0.65
0.49-0.69
0.78
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53
206
95
136
153
113
88
125
69
Norwegian – right
2013 Norwegian – left
2011 Egyptian
2008 Sami
Danish -right
2005 Danish -left
2007 Saudi
2005 Turkish
2003 Malawian
Japanese
2000 French
Japanese
1998 British
1998 Korean
Caucasian - right
1997 Caucasian - left
1996 Indian
1996 Nigerian
1995 British
1995 Chinese
1991 British
1973 Hong Kong Chinese
pelvic
pelvic
pelvic
pelvic
pyelogram
urogram
urogram
pelvic
urogram
Type of
radiograph
2604
2072
2072
488
315
3859
3859
208
184
180
1538
783
395
2993
1182
251
247
262
126
393
1993
18-19
18-60
20-64
22-93
40-88
55-97
N/A
20-79
20-79
60-79
60-75
22-88
65+
18-73
60-75
60-75
60-75
60-75
60-74
(years)
hips
74
Age
N
3.0
2.0
3.6
21
3.5*
3.5*
0.0
0.0
2.2
0
F
1.6
1.1
2.3
14
3.6*
3.1*
0.0
2.3
1.3
0
1.1
1.0
M
CE<20Û
* The lateral margin of the subcondral sclerotic sourcil was used as the lateral point of reference (Ogata’s point)
Engesæter et al.
Aly et al.
9
Johnsen et al.
255
120
159
160
Jacobsen et al.
Moussa et al.
Goker et al.
Msamati et al.
Inoue et al.
Yoshimura et al.
Han et al.
Lane et al.
Mandal et al.
Ali-Gombe et al.
Smith et al.
Lau et al.
140
Croft et al.
6
105
Hoaglund et al.
Year Population group
16
14
5.5
24
7.4
13
12
5.6
19
4.0
2.4
4.0
3.9
3.8
F
12
10
4.5
17
10
12
5.1
1.8
16
4.0
3.8
2.4
4.5
3.6
5
M
CE<25Û
7.9
7.6
8.4
7.7
F
8.7
8.1
10.7
9.8
M
ADR<250
11
11
8.4
8.2
F
3.8
2.9
3.4
3.2
M
Sharp>45Û
4.5
2.7
2.3
1.4
F
3.6
2.4
5.6
4.5
M
FHEI<75%
Authors
Table 6 Occurrence in percent of adult hip dysplasia in the literature based on Wiberg’s centre-edge (CE) angle, acetabular depth-width
ratio (ADR), Sharp’s angle and femoral head extrusion index (FHEI) for females (F) and males (M).
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13. SOURCES OF DATA
$GHEDMR$23DWWHUQRIRVWHRDUWKULWLVLQD:HVW$IULFDQWHDFKLQJKRVSLWDOAnn
Rheum Dis 1991;50-1:20-2.
$JXV+%LFLPRJOX$2PHURJOX+7XPHU<+RZVKRXOGWKHDFHWDEXODUDQJOH
RI6KDUSEHPHDVXUHGRQDSHOYLFUDGLRJUDSK"J Pediatr Orthop 2002;22-2:228-31.
$KPDG0$;\SQLWRV)1*LDQQRXGLV390HDVXULQJKLSRXWFRPHVFRPPRQ
VFDOHVDQGFKHFNOLVWVInjury 2011;42-3:259-64.
$NWDV63HNLQGLO*(UFDQ63HNLQGLO<$FHWDEXODUG\VSODVLDLQQRUPDO
7XUNLVKDGXOWVBulletin 2000;59-3:158-62.
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GLVORFDWLRQRIWKHKLSGLDJQRVHGODWH$TXDQWLWDWLYHVWXG\J Bone Joint Surg Am
1996;78-7:1048-55.
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G\VSODVLDLQ1LJHULDQPHQJ Rheumatol 1996;23-3:512-5.
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FOLQLFDOYDOLGLW\Eur Radiol 2007;17-8:1960-7.
5RVHU:hEHUDQJHERUHQH+IWYHUUHQNXQJLangenbecks Arch Klin Chir
1879;24:309-13.
6DOWHU5%(WLRORJ\SDWKRJHQHVLVDQGSRVVLEOHSUHYHQWLRQRIFRQJHQLWDO
GLVORFDWLRQRIWKHKLSCan Med Assoc J 1968;98-20:933-45.
6DQFKH]6RWHOR-%HUU\'-7URXVGDOH57&DEDQHOD0(6XUJLFDOWUHDWPHQW
RIGHYHORSPHQWDOG\VSODVLDRIWKHKLSLQDGXOWV,,$UWKURSODVW\RSWLRQVJ Am Acad
Orthop Surg 2002;10-5:334-44.
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UDQGRPL]HGFRQWUROOHGWULDOLQHYDOXDWLQJSRSXODWLRQEDVHGKHDOWKLQWHUYHQWLRQVAm J
Prev Med 2007;33-2:155-61.
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UHVXOWVRIFORVHGUHGXFWLRQDQGDUWKURJUDSKLFVWXGLHVRIUHFHQWFDVHVActa Chirurgica
Scandinavica 1941;Suppl 63-84:1-142.
6KDUS,.$FHWDEXODU'\VSODVLDJ Bone Joint Surg 1961;43B-2:268-72.
6KL<</LX7-=KDR4=KDQJ/--L6-:DQJ(%7KHQRUPDOFHQWUHHGJH
DQJOHRI:LEHUJLQWKH&KLQHVHSRSXODWLRQDSRSXODWLRQEDVHGFURVVVHFWLRQDOVWXG\
J Bone Joint Surg Br 2010;92-8:1144-7.
6KRUWHU'+RQJ72VERUQ'$6FUHHQLQJSURJUDPPHVIRUGHYHORSPHQWDO
G\VSODVLDRIWKHKLSLQQHZERUQLQIDQWV5HYLHZCochrane Database Syst Rev.9RO
7KH&RFKUDQH/LEUDU\
6NRPVYROO-VWHQVHQ0%DVWH9,UJHQV/9DOLGLW\RIDUKHXPDWLFGLVHDVH
GLDJQRVLVLQWKH0HGLFDO%LUWK5HJLVWU\RI1RUZD\Acta Obstet Gynecol Scand
2002;81-9:831-4.
6PLWK$-'LHSSH3+RZDUG3:%ORP$:1DWLRQDO-RLQW5HJLVWU\IRU(
:DOHV)DLOXUHUDWHVRIPHWDORQPHWDOKLSUHVXUIDFLQJVDQDO\VLVRIGDWDIURPWKH
1DWLRQDO-RLQW5HJLVWU\IRU(QJODQGDQG:DOHVLancet 2012;380-9855:1759-66.
6PLWK5:(JJHU3&RJJRQ'&DZOH\0,&RRSHU&2VWHRDUWKULWLVRIWKH
KLSMRLQWDQGDFHWDEXODUG\VSODVLDLQZRPHQAnn Rheum Dis 1995;54-3:179-81.
6WDPQHV20DUNHVWDG7+ROH-6HLPH6>+LSMRLQWOX[DWLRQLQQHZERUQ
LQIDQWV$GLDJQRVWLFSUREOHP@Tidsskrift for den Norske lægeforening : tidsskrift for
praktisk medicin, ny række 1986;106-31:2607-9.
6WDQLVDYOMHYLF67ULEXWHWR0DULQR2UWRODQLClin Orthop Relat Res 1976119:4-5.
6WUD\HU/07KH(PEU\RORJ\RIWKH+XPDQ+LS-RLQWThe Yale journal of
biology and medicine 1943;16-1:13-26 6.
6WXEEV$-$Q]$:)ULQR-/DQJ-(:HDYHU$$6WLW]HO-'&ODVVLF
PHDVXUHVRIKLSG\VSODVLDGRQRWFRUUHODWHZLWKWKUHHGLPHQVLRQDOFRPSXWHU
WRPRJUDSKLFPHDVXUHVDQGLQGLFHVHip Int 2011;21-5:549-58.
6WXOEHUJ6'&RRSHUPDQ'5:DOOHQVWHQ57KHQDWXUDOKLVWRU\RI/HJJ
&DOYH3HUWKHVGLVHDVHJ Bone Joint Surg Am 1981;63-7:1095-108.
6WXOEHUJ6'+DUULV:+$FHWDEXODUG\VSODVLDDQGGHYHORSPHQWRI
RVWHRDUWKULWLVRIWKHKLS,Q+DUULV:+HGThe Hip. Proceedings of the Second Open
Scientific Meeting of the Hip Society.6W/RXLV
6XVKLO69HUPD14XHVWLRQQDLUH9DOLGDWLRQ0DGH(DV\European Journal of
Scientific Research 2010;46-2:172-8.
7DQ/$NWDV6&RSXURJOX&2]FDQ07XUH05HOLDELOLW\RIUDGLRORJLFDO
SDUDPHWHUVPHDVXUHGRQDQWHURSRVWHULRUSHOYLVUDGLRJUDSKVRISDWLHQWVZLWK
GHYHORSPHQWDOG\VSODVLDRIWKHKLSActa orthopaedica Belgica 2001;67-4:374-9.
7DQQDVW00LVWU\66WHSSDFKHU6'5HLFKHQEDFK6/DQJORW])
6LHEHQURFN.$=KHQJ*5DGLRJUDSKLFDQDO\VLVRIIHPRURDFHWDEXODULPSLQJHPHQW
ZLWK+LS1RUPUHOLDEOHDQGYDOLGDWHGJ Orthop Res 2008;26-9:1199-205.
7HJQDQGHU$+ROHQ.-$QGD67HUMHVHQ7*RRGUHVXOWVDIWHUWUHDWPHQW
ZLWKWKH)UHMNDSLOORZIRUKLSG\VSODVLDLQQHZERUQVD\HDUWR\HDUIROORZXS
VWXG\J Pediatr Orthop B 2001;10-3:173-9.
7HOOLQL$&LFFRQH9%ORQQD'5RVVL50DUPRWWL$&DVWROGL)4XDOLW\RI
OLIHHYDOXDWLRQLQSDWLHQWVDIIHFWHGE\RVWHRDUWKULWLVVHFRQGDU\WRFRQJHQLWDOKLS
G\VSODVLDDIWHUWRWDOKLSUHSODFHPHQWJ Orthop Traumatol 2008;9-3:155-8.
7HUMHVHQ7%UHGODQG7%HUJ98OWUDVRXQGIRUKLSDVVHVVPHQWLQWKH
QHZERUQJ Bone Joint Surg Br 1989;71-5:767-73.
7HUMHVHQ7+ROHQ.-7HJQDQGHU$+LSDEQRUPDOLWLHVGHWHFWHGE\XOWUDVRXQG
LQFOLQLFDOO\QRUPDOQHZERUQLQIDQWVJ Bone Joint Surg Br 1996;78-4:636-40.
7KH(XUR4RO*URXS(XURTROD1HZ)DFLOLW\IRUWKH0HDVXUHPHQWRI+HDOWK
5HODWHG4XDOLW\RI/LIHHealth Policy 1990;16-3:199-208.
7KH1RUZHJLDQ$UWKURSODVW\5HJLVWHU$QQXDO5HSRUW,Q5HJLVWHU71$HG
7KH1RUZHJLDQ$UWKURSODVW\5HJLVWHU
7KH1RUZHJLDQ'LUHFWRUDWHRI+HDOWK>1DVMRQDOHIDJOLJHUHWQLQJVOLQMHU
+¡ULQJVXWNDVWUHWQLQJVOLQMHIRUEDUVHORPVRUJHQ@
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7KH:+242/*URXS7KH:RUOG+HDOWK2UJDQL]DWLRQ4XDOLW\RI/LIH
$VVHVVPHQW:+242/GHYHORSPHQWDQGJHQHUDOSV\FKRPHWULFSURSHUWLHVSoc Sci
Med 1998;46-12:1569-85.
7KLOOHPDQQ703HGHUVHQ$%-RKQVHQ636¡EDOOH.,PSODQWVXUYLYDODIWHU
SULPDU\WRWDOKLSDUWKURSODVW\GXHWRFKLOGKRRGKLSGLVRUGHUVUHVXOWVIURPWKH'DQLVK
+LS$UWKURSODVW\5HJLVWU\Acta Orthop 2008;79-6:769-76.
7LHQ<&6X-</LQ*7/LQ6<8OWUDVRQRJUDSKLFVWXG\RIWKHFRH[LVWHQFHRI
PXVFXODUWRUWLFROOLVDQGG\VSODVLDRIWKHKLSJ Pediatr Orthop 2001;21-3:343-7.
7URHOVHQ$5¡PHU/.ULQJ6(OPHQJDDUG%6¡EDOOH.$VVHVVPHQWRIKLS
G\VSODVLDDQGRVWHRDUWKULWLVYDULDELOLW\RIGLIIHUHQWPHWKRGVActa Radiol 2010;512:187-93.
7|QQLV'1RUPDOYDOXHVRIWKHKLSMRLQWIRUWKHHYDOXDWLRQRI;UD\VLQFKLOGUHQ
DQGDGXOWVClin Orthop Relat Res 1976-119:39-47.
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7|QQLV'%UXQNHQ'>'LIIHUHQWLDWLRQRIQRUPDODQGSDWKRORJLFDODFHWDEXODU
URRIDQJOHLQWKHGLDJQRVLVRIKLSG\VSODVLD(YDOXDWLRQRIDFHWDEXODUURRIDQJOHV
RIKLSMRLQWVLQFKLOGUHQ@Arch Orthop Unfallchir 1968;64-3:197-228.
7|QQLV'+HLQHFNH$$FHWDEXODUDQGIHPRUDODQWHYHUVLRQUHODWLRQVKLSZLWK
RVWHRDUWKULWLVRIWKHKLSJ Bone Joint Surg Am 1999;81-12:1747-70.
7|QQLV'/HJDO+*UDI5Congenital dysplasia and dislocation of the hip in
children and adults. 1HZ<RUN6SULQJHU9HUODJ
8OOPDQQ.=XU)UDJHGHUU|QWJHQRORJLVFKHQ%HXUWHLOXQJGHVNQ|FKHUQHQ
3IDQQHQGDFKHVPLWZHLWHUHQ(UJHEQLVVHQGHU5|QWJHQVWDPPEDXPIRUVFKXQJZ
Orthop 1939;69:268-71.
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KHDOWKVWDWHYDOXDWLRQVFROOHFWHGZLWKWKH(XUR4ROTXHVWLRQQDLUHSoc Sci Med
1994;39-11:1537-44.
YDQ6OHXZHQ%((QJHOEHUWV$&%RHUH%RRQHNDPS00.XLV:
6FKXOSHQ7:/
+RLU036ZDGGOLQJDV\VWHPDWLFUHYLHZPediatrics 2007;1204:e1097-106.
9RJHO,$QGHUVVRQ-(8OGEMHUJ16HUXPUHOD[LQLQWKHQHZERUQLVQRWD
PDUNHURIQHRQDWDOKLSLQVWDELOLW\J Pediatr Orthop 1998;18-4:535-7.
YRQ.ULHV5,KPH12EHUOH'/RUDQL$6WDUN5$OWHQKRIHQ/1LHWKDUG
)8(IIHFWRIXOWUDVRXQGVFUHHQLQJRQWKHUDWHRIILUVWRSHUDWLYHSURFHGXUHVIRU
GHYHORSPHQWDOKLSG\VSODVLDLQ*HUPDQ\Lancet 2003;362-9399:1883-7.
:DOG1/HFN,HGVAntenatal and neonatal screening.QGHGLWLRQHG1HZ
<RUN2[IRUG8QLYHUVLW\3UHVV
:DOVK--0RUULVV\577RUWLFROOLVDQGKLSGLVORFDWLRQJ Pediatr Orthop
1998;18-2:219-21.
:DOWKHU70RH%'\VSODVLDFR[DHFRQJHQLWDOX[DWLRHWVXEOX[DWLRFR[DH
FRQJHQLWDTidsskr Nor Laegeforen 1954;74-20:643-5.
:DQJ(/LX7/L-(GPRQGV(:=KDR4=KDQJ/=KDR;:DQJ.
'RHVVZDGGOLQJLQIOXHQFHGHYHORSPHQWDOG\VSODVLDRIWKHKLS"$QH[SHULPHQWDO
VWXG\RIWKHWUDGLWLRQDOVWUDLJKWOHJVZDGGOLQJPRGHOLQQHRQDWDOUDWVJ Bone Joint
Surg Am 2012;94-12:1071-7.
:HLQVWHLQ6/1DWXUDOKLVWRU\RIFRQJHQLWDOKLSGLVORFDWLRQ&'+DQGKLS
G\VSODVLDClin Orthop Relat Res 1987-225:62-76.
:HLQVWHLQ6/1DWXUDOKLVWRU\DQGWUHDWPHQWRXWFRPHVRIFKLOGKRRGKLS
GLVRUGHUVClin Orthop Relat Res 1997-344:227-42.
:HVWEHUU\'('DYLGV-53XJK/,&OXEIRRWDQGGHYHORSPHQWDOG\VSODVLDRI
WKHKLSYDOXHRIVFUHHQLQJKLSUDGLRJUDSKVLQFKLOGUHQZLWKFOXEIRRWJ Pediatr
Orthop 2003;23-4:503-7.
:LEHUJ*6WXGLHVRQG\VSODVWLFDFHWDEXODDQGFRQJHQLWDOVXEOX[DWLRQRIWKHKLS
MRLQWActa Orthop Scand Suppl 1939;58:1-132.
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Scand 2002;73-5:523-30.
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KLSJ Bone Joint Surg Br 1963;45-B-2:268-83.
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HYLGHQFHIRUWKHUROHRIORZEDFNSDLQV\PSWRPFRXQWVIDWLJXHDQGGHSUHVVLRQLQ
RVWHRDUWKULWLVUKHXPDWRLGDUWKULWLVDQGILEURP\DOJLDRheumatology (Oxford)
1999;38-4:355-61.
:ROIH)+DZOH\'-0HDVXUHPHQWRIWKHTXDOLW\RIOLIHLQUKHXPDWLFGLVRUGHUV
XVLQJWKH(XUR4ROBr J Rheumatol 1997;36-7:786-93.
:RRODFRWW1)3XKDQ0$6WHXUHU-.OHLMQHQ-8OWUDVRQRJUDSK\LQ
VFUHHQLQJIRUGHYHORSPHQWDOG\VSODVLDRIWKHKLSLQQHZERUQVV\VWHPDWLFUHYLHZ
BMJ 2005;330-7505:1413.
:\QQH'DYLHV5$FHWDEXODUG\VSODVLDDQGIDPLOLDOMRLQWOD[LW\WZRHWLRORJLFDO
IDFWRUVLQFRQJHQLWDOGLVORFDWLRQRIWKHKLS$UHYLHZRISDWLHQWVDQGWKHLU
IDPLOLHVJ Bone Joint Surg Br 1970;52-4:704-16.
:\QQH'DYLHV5$IDPLO\VWXG\RIQHRQDWDODQGODWHGLDJQRVLVFRQJHQLWDO
GLVORFDWLRQRIWKHKLSJournal of medical genetics 1970;7-4:315-33.
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DFHWDEXODUG\VSODVLDDQGMRLQWOD[LW\RIIHPDOHDQWHULRUFUXFLDWHOLJDPHQWLQMXUHG
SDWLHQWVAm J Sports Med 2011;39-2:410-4.
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%ULWDLQDQG-DSDQBritish journal of rheumatology 1998;37-11:1193-7.
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15. APPENDICES
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Melding om avsluttet svangerskap etter 12. uke – Fødsel, dødfødsel, spontanabort
Se utfyllingsinstruks for blanketten på baksiden
Mors fulle navn og adresse
A – Sivile opplysninger
Institusjonsnr:
Hjemme, planlagt
Hjemme, ikke planlagt
Mors
sivilstatus
Gift
Ugift/enslig
Samboer
Skilt/separert/enke
Slektskap mellom
barnets foreldre?
Nei
Fars fulle navn
Siste menstr.
1. blødn.dag
Sikker
B – Om svangerskap og mors helse
Mors
fødselsnr:
Mors tidligere
svangerskap/fødte
Usikker
Nei
Spesielle
forhold under
svangerskapet:
Intet spesielt
Nei
Kronisk hypertensjon
Diabetes type 1
Tidligere sectio
Reumatoid artritt
Diabetes type 2
Res. urinveisinfeksjon
Hjertesykom
Annet, spesifiser i «B» Folat/Folsyre
Blødning < 13 uke
Hypertensjon alene
Eklampsi
Blødning 13–28 uke
Preeklampsi lett
Hb < 9.0 g/dl
Blødning > 28 uke
Preeklampsi alvorlig
Hb > 13.5 g/dl
Glukosuri
Preeklampsi før 34. uke
Trombose, beh.
Nei
Svangerskapsdiabetes
HELLP syndrom
Infeksjon, spes. i «B»
Mors
yrke
Ja – spesifiser i «B»
Røykte mor ved
sv.sk. begynnelse?
- ved sv.sk.
avslutning?
Samtykker ikke for røykeoppl.
Nei
Av og til
Daglig
Ant. sig. dagl.:
Nei
Av og til
Nei
Før sv.sk. I sv.sk.
Multivitaminer
Samtykker ikke for yrkesoppl. Mors yrke
Ikke yrkesaktiv
Yrkesaktiv deltid
Ev. induksjonsmetode:
Indikasjon for
inngrep og/eller
induksjon
Prostaglandin
Tverrleie
Spontan
Avvikende hodefødsel
Indusert
Amniotomi
Annet, spesifiser i «C»
Sectio
Oxytocin
Vanlig fremhjelp
Vakuumekstraktor
Uttrekning
Utført som elektiv sectio
Episitomi
Tang på etterk. hode
Utført som akutt sectio
Vannavg. 12–24 timer
Placenta previa
Blødn.> 1500 ml, transf.
Truende intrauterin asfyksi
Vannavg. > 24 timer
Abruptio placentae
Blødning 500–1500 ml
Risvekkelse, stimulert
Mekaniske misforhold
Perinealruptur (grad 1-2)
Eklampsi under fødsel
Langsom fremgang
Vanskelig skulderforløsning
Sphincterruptur (gr. 3-4)
Navlesnorfremfall
Uterus atoni
Lystgass
Epidural
Pudendal
Paracervical blokk
Spinal
Infiltrasjon
Petidin
Koagler
Sectio:
Spesifikasjon av forhold ved fødselen/andre komplikasjoner
Var sectio planlagt før fødsel?
Nei
C
Annet:
Annet:
Fostervann
Komplikasjoner hos mor etter fødsel
Normal
Utskrapning
Normal
Annet omslyng
Normal
Misfarget
Intet spesielt
Mor overflyttet
Hinnerester
Manuell uthenting
Velamentøst feste
Ekte knute
Polyhydramnion
Stinkende, infisert
Feber > 38.5˚
Mor intensivbeh.
Oligohydramnion
Blodtilblandet
Trombose
Sepsis
Ufullstendig
Infarkter
Marginalt feste
Placentavekt
Fødselsdato
Navlesnorlengde:
Karanomalier
Klokken
For flerfødsel:
Pluralitet
Enkeltfødsel
Flerfødsel
Nr.
Kjønn
Av
totalt
For dødfødte:
Levendefødt
Dødfødt/sp.abort
Oppgi dødsårsak i «D»
Gutt
Barnets
vekt:
Pike
Ved tvil spesifiser i «D»
Ja
Død før innkomst
Ukjent dødstidspunkt
Død etter innkomst
D
Usikkert kjønn
Hodeomkrets:
Levendefødt, død innen 24 timer
Livet
varte:
Timer
Indikasjon for
overflytting:
Apgar score:
Total
lengde:
1 min
Eventuelt
sete–issemål:
5 min
Død senere (dato):
Min.
Medfødte misd.
Prematur
Perinatale infeksjoner
Transit. tachypnoe
Cerebral irritasjon
Konjunktivitt beh.
Fract. claviculae
Medf. anemi (Hb < 13.5 g/dl)
Resp. distress syndr.
Cerebral depresjon
Navle./hudinf. beh.
Annen fraktur
Systemisk antibiotika
Hofteleddsdyspl. beh. m/pute
Aspirasjonssyndrom
Abstinens
Perinat. inf. bakterielle
Facialisparese
Respiratorbeh.
Intrakraniell blødning
Neonatale kramper
Perinat. inf. andre
Plexusskade
CPAP beh.
Behandlingskoder:
Spesifikasjon av skader, neonatale diagnoser og medfødte misdannelser – utfylles av lege
Annet, spesifiser
Icterus behandlet:
Lysbehandlet
Utskifting
Årsak:
AB0 uforlik.
RH immunisering
Fysiologisk
Annen årsak
Ja
Kryss av hvis skjema
er oppfølgingsskjema
Utskrivningsdato
Jordmor v/fødsel:
Mor:
Jordmor v/utskrivning:
Protokollnr.:
Klokken
Respirasjonsproblem
Hypoglyk. (< 2 mmol/l)
Intet spesielt
Nei
Død under fødselen
Dato:
Neonatale diagn.:
(Fylles ut av
lege/pediater)
Tegn til
medfødte
misdannelser:
For dødfødte, oppgi også
Overfl. til
Overfl. barneavd.
Nei
Død før fødsel
Annet, spesifiser
Eklampsi post partum
For dødfødte:
Barnet var:
D – Om barnet
Ja
Narkose
Omslyng rundt hals
Navlesnor
Fostermisdannelser
Annen tang, hodeleie
Ingen
Komplikasjoner som beskrevet nedenfor
Overtid
Ingen
Placenta:
23011. 07.06. Andvord Grafisk.
Bransje:
Yrkesaktiv heltid
Ant. sig. dagl.:
Fremhj. ved setefødsel:
Anestesi/analgesi:
B
Legemidler i svangerskapet:
Utskj. tang, hodeleie
Ingen
Ja, hvis bekreftet – spesifiser
Annet, spesifiser i «B»
Inngrep/tiltak
Komplikasjoner
Nei
Spesifikasjon av forhold før eller under svangerskapet:
Regelmessig kosttilskudd:
Daglig
Fødselstart:
Sete
Epilepsi
Spontanaborter
(under 12. uke)
Patologiske funn ved
prenatal diagnostikk?
Ja, angi type:
Allergi
Skriftlig orientering gitt til mor
IS-1002
Spontanabort/Dødfødte (12.–23. uke)
Kronisk nyresykdom
Forutsetter mors samtykke
– se rettledning på baksiden
Normal
bakhode
Dødfødte (24.
uke og over)
Astma
Røyking og yrke
Leie/presentasjon:
Levendefødte
Annen prenatal
diagnostikk?
UL
Ja termin:
Intet spesielt
Pikenavn (etternavn):
Annet sted
Mors
bokommune
Fars
fødselsdato
Spesielle forhold
før svangerskapet:
Under transport
Annet
Hvis ja,
hvorledes:
Ja
Ultralyd utført?
C – Om fødselen
Fødsel utenfor institusjon:
Institusjonsnavn
/
Lege:
Lege
barsel/barneavd:
Barn:
Nasjonalt Register for Leddproteser
Ortopedisk klinikk, Helse Bergen HF
Haukeland universitetssjukehus
Møllendalsbakken 11, 5021 BERGEN
Tlf 55973742/55973743
HOFTEPROTESER
F.nr. (11 sifre).....................................................................
Navn:..................................................................................
(Skriv tydelig ev. pasient klistrelapp – spesifiser sykehus.)
Sykehus:............................................................................
ALLE TOTALPROTESER I HOFTELEDD REGISTRERES. Innsetting, skifting og fjerning av totalproteser i hofteledd, samt
kantplastikk, bløtdelsrevisjon for infisert protese og hemiproteser på annen indikasjon enn fraktur/fraktursekvele.
Hemiprotese for fraktur/fraktursekvele registreres på Hoftebruddskjema.
TIDLIGERE OPERASJON I AKTUELLE HOFTE (ev. flere kryss)
0 Nei
1 Osteosyntese for fraktur i prox. femurende
2 Hemiprotese pga. fraktur
3 Osteotomi
4 Artrodese
5 Totalprotese(r)
6 Annen operasjon …………………………………………………....................
OPERASJONSDATO (dd.mm.åå)
AKTUELLE OPERASJON (ett kryss)
1 Primæroperasjon (også hvis hemiprotese tidligere)
2 Reoperasjon (totalprotese tidligere)
3 Primær hemiprotese for annen indikasjon enn fraktur/fraktursekvele
AKTUELLE SIDE (ett kryss) (Bilateral opr.= 2 skjema)
1 Høyre
2 Venstre
ÅRSAK TIL AKTUELLE OPERASJON (KRYSS AV ENTEN I A ELLER B)
A Primæroperasjon pga. (evt. flere kryss)
1 Idiopatisk coxartrose
2 Rheumatoid artritt
3 Sekvele etter frakt. colli. fem.
4 Sekv. dysplasi
5 Sekv. dysplasi med total luksasjon
6 Sekv. Perthes
7 Sekv. Epifysiolyse
8 Mb. Bechterew
9 Akutt fraktura colli femoris
Annet ……….......….....…………………………………………………….........
(f.eks caputnekrose, tidl. artrodese o.l)
B Årsak til reoperasjon (evt. flere kryss)
1 Løs acetabularkomponent
10 Implantatfraktur femurdel
2 Løs femurkomponent
11 Implantatfraktur caput
3 Luksasjon
12 Implantatfraktur kopp
4 Dyp infeksjon
13 Implantatfraktur liner
5 Fraktur (i acetabulum)
14 Implantatfraktur annet: ............
6 Fraktur (av femur)
..................................................
7 Smerter
8 Osteolyse i acetab. uten løsning
9 Osteolyse i femur uten løsning
Annet ………………….......………………....………………………..…..........
(f.eks Girdlestonesituasjon etter tidl. infisert protese)
REOPERASJONSTYPE (ev. flere kryss)
1 Bytte av femurkomponent
2 Bytte av acetabularkomponent
3 Bytte av hele protesen
4 Fjernet protese og satt inn sementspacer
5 Fjernet sementspacer og satt inn ny protese
6 Fjernet protese (Girdlestone eller fjerning av sementspacer)
Angi hvilke deler som ble fjernet …………....…………………………...........
7 Bytte av plastforing
8 Bytte av caput
9 Bløtdelsdebridement for infisert protese
Andre operasjoner …………………………………………….………..............
TILGANG (ett kryss)
1 Fremre (Mellom sartorius og tensor)
3 Direkte lateral (Transgluteal)
2 Anterolateral (Mellom glut. medius og tensor)
4 Bakre (Bak gluteus medius)
5 Annen ……………………………………………………………………..........
MINIINVASIV KIRURGI (MIS)
0
Nei
LEIE
0
Sideleie
1
Rygg
TROKANTEROSTEOTOMI
0
Nei
1
Ja
1
Ja
BENTRANSPLANTASJON (ev. flere kryss)
0 Nei
1 Ja
2 Benpakking
Acetabulum
0 Nei
1 Ja
2 Benpakking a.m. Ling/Gie
Femur
BENTAP VED REVISJON (Paprosky’s klassifikasjon se baksiden)
1I
2 IIA
3 IIB
4 IIC
5 IIIA
Acetabulum
1I
2 II
3 IIIA
4 IIIB
5 IV
Femur
6
IIIB
PROTESEKOMPONENTER
(Bruk klistrelapp på baksiden, eller spesifiser nøyaktig)
Acetabulum
Navn/Type ……..............……………………………………………………………….............
ev. katalognummer ………........…………………………………………………...........
Med hydroksylapatitt
Uten hydroksylapatitt
1 Sement med antibiotika – Navn ………………………………………..................
2 Sement uten antibiotika – Navn ………………………………………..................
3 Usementert
Femur
Navn/Type …………………………………………………………………….............
ev. katalognummer …………………………………………………………...........
Med hydroksylapatitt
Uten hydroksylapatitt
1 Sement med antibiotika – Navn ………………………………………..................
2 Sement uten antibiotika – Navn ………………………………………..................
3 Usementert
4 Resurfacing
Caput
1 Fastsittende caput
2 Separat caput - Navn/Type ……………………………………………..................
ev. katalognummer …………………………………………………………............
Diameter ………………
SYSTEMISK ANTIBIOTIKA
0 Nei
1 Ja:
1 Profylakse
2
Behandling
Navn
Dosering
Varighet i timer (døgn)
Medikament 1 ..........................................……..….....…...............…. ......timer (......døgn)
Medikament 2 ..........................................………..…..…................... ......timer (......døgn)
Medikament 3 .................................................................……..…….. ......timer (......døgn)
TROMBOSEPROFYLAKSE
0 Nei
1 Ja: Første dose
1 Preoperativt
2 Postoperativt
Medikament 1 ............................. Dosering opr.dag…………………………………….....
Dosering videre ………..........… Varighet …… døgn
Medikament 2 ............................. Dosering …………..................... Varighet …… døgn
Fast antikoagulasjon
0 Nei
1
Ja, type ..........................................................................................................
FIBRINOLYSEHEMMER
0 Nei
1 Ja, medikament: …………………………………….. Dosering ……………......
OPERASJONSSTUE
1 ”Green house”
2 Operasjonsstue med laminær luftstrøm
3 Vanlig operasjonsstue
OPERASJONSTID (hud til hud) …………………………min
PEROPERATIV KOMPLIKASJON
0 Nei
1 Ja, hvilke(n) ............................................................................................................
ASA KLASSE (se baksiden for definisjon)
1 Frisk
2 Asymptomatisk tilstand som gir økt risiko
3 Symptomatisk sykdom
4 Livstruende sykdom
5 Moribund
Lege ...................................................................................................
Legen som har fylt ut skjemaet (navnet registreres ikke i databasen).
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Besøksadresse: Haukeland Universitetssykehus, Jonas Liesvei 65, Postadresse: Helse Bergen HF, Postboks 1, 5021 Bergen
Telefon 55 97 50 00 – Innvalg 55 97 28 90 – Telefaks 55 97 49 34 E-post: postmottak@helse-bergen.no
Foretaksnr. NO 983974724 mva. Internett: www.helse-bergen.no
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NAVN
Tidligere hofteplager eller andre leddplager
Før du møter til undersøkelse er det fint om du spør foreldrene dine om du noen gang har hatt
noe galt med hoftene dine eller en annen leddlidelse. Kryss av i rubrikkene under på det som er
aktuelt. Leveres med samtykkeerklæringen.
Ingen problemer
Medfødt hofteleddsdysplasi
Serøs coxitt (ikke-bakteriell betennelse i hofteleddet)
Septisk artritt i hofteledd (bakteriell betennelse i hofteleddet)
Calvé Legg Perthes` sykdom
Epifysiolyse
Brudd
Leddgikt (Reumatoid artritt)
Annet (Spesifiser:……………………………………………………………….)
Vet ikke
Har oppsøkt lege / Legevakt pga. problemer med hofte. Spesifiser:………………….
Har du noen sykdom som har vart over 3 måneder? Hvilken:………………………….
Hofteplager i nærmeste familie
Har du søsken som har medfødt hoftelidelse og har vært behandlet med pute?
Ja
Nei
Vet ikke Hvis ”ja”, antall: ( eks. 1 bror 2 søstre )
......bror/brødre …...søster/søstre ……halvbror/halvbrødre …..halvsøster/halvsøstre
Ja
Nei
Vet ikke
Ja
Nei
Vet ikke
Har du foreldre som har hatt medfødt hoftelidelse?
Hvis ”ja”, hvem:
mor
far
Har foreldrene dine plager med hoftene i dag?
Hvis ”ja”, hvem:
Mors høyde………cm
mor
far
Fars høyde………cm
+2)7(
HOFTE 89
Haukeland Universitetssykehus
Mange takk for at du tar deg tid til å være med på Hoftestudien. Skjema brukes også for
undersøkelse av helsetilstanden til eldre og alvorlig syke personer. Noen av spørsmålene kan
derfor virke lite relevante for deg om du er helt frisk. Likevel ber vi deg lese gjennom hele
skjema, og svare på alle spørsmålene. Der er totalt 43 spørsmål.
1. Deltakernummer:………………….
2. Navn: ……………………………………………………
3. Fødselsnummer: |__|__| |__|__| |__|__| |__|__|__|__|__|
4. Yrke
skoleelev
annet (Spesifiser:…………………………….)
5. Har du noen gang hatt plager fra høyre hofte (varighet over 1 måner)?
Ja
Nei
Hvis ”JA”, spesifiser………………………………………….
6. Har du hatt plager fra høyre hofte siste 3 måneder?
Ja
Nei
7. Har du noen gang hatt plager fra venstre hofte (varighet over 1 måner)?
Ja
Nei
8. Har du hatt plager fra venstre hofte siste 3 måneder?
Ja
Nei
9. Hvor ofte har du vondt i nakken?
omtrent hver dag
mer enn 1 gang pr uke
omtrent hver uke
omtrent hver måned
sjelden eller aldri
2
10. Hvor ofte har du vondt i ryggen?
omtrent hver dag
mer enn 1 gang pr uke
omtrent hver uke
omtrent hver måned
sjelden eller aldri
11. Har du problemer som du relaterer til hoften, som gjør at du har vansker med å gå?
Ja
Nei
12. Er det andre årsaker enn hofteplager som gjør at du har vansker med å gå?
(For eksempel smerter fra andre ledd, ryggsmerter, hjerte-karsykdom eller andre
sykdommer som påvirker gangevnen din)
Ja
Nei
Hvis ”JA”, spesifiser………………………………………
13. Utenom skoletid: Hvor mange GANGER i uken driver du med idrett/mosjon slik at du
blir andpusten og/eller svett?
hver dag
4-6 ganger i uken
2-3 ganger i uken
1 gang i uken
1 gang i måneden
mindre enn 1 gang i måneden
aldri
14. Utenom skoletid: Hvor mange TIMER i uken driver du med idrett/mosjon slik at du blir
andpusten og/eller svett?
ingen
½ time
1 time
2-3 timer
4-6 timer
7 timer eller mer
3
SMERTE- Tenk på smerten du opplevde I HOFTEN i løpet av de siste 48 timer.
15. Hvor mye smerter har du når du går på flatt underlag?
ingen
litt
moderat
stor
svært stor
16. Hvor mye smerte har du når du går opp og ned trapper?
ingen
litt
moderat
stor
svært stor
17. Hvor mye smerte har du om natten når du ligger i sengen?
ingen
litt
moderat
stor
svært stor
18. Hvor mye smerter har du når du sitter eller ligger?
ingen
litt
moderat
stor
svært stor
19. Hvor mye smerter har du når du står oppreist
ingen
litt
moderat
stor
svært stor
STIVHET- Tenk på stivheten du har opplevd i HOFTEN i løpet av de siste 48 timer
20. Hvor alvorlig er stivheten i hoften din med en gang du våkner om morgenen?
ingen
litt
moderat
kraftig
svært kraftig
21. Hvor alvorlig er stivheten i hoften din etter at du sitter ligger eller hviler senere på dagen?
ingen
litt
moderat
kraftig
svært kraftig
FUNKSJON- Tenk på hvor vanskelig det har vært å utføre følgende daglige fysiske
aktiviteter i løpet av de siste 48 timene, som følge av SMERTE I HOFTEN. Med dette
mener vi din bevegelsesevne og evne til å klare deg selv.
SPØRSMÅL: Hvor vanskelig har det vært å........
22. gå ned trapper?
ingen
litt
moderat
svært
ekstremt
moderat
svært
ekstremt
litt
moderat
svært
ekstremt
litt
moderat
svært
ekstremt
svært
ekstremt
23. gå opp trapper?
ingen
litt
24. reise deg fra sittende?
ingen
25. stå oppreist?
ingen
26. bøye deg ned mot gulvet?
ingen
litt
moderat
4
27. gå på flatt underlag?
ingen
litt
moderat
svært
ekstremt
moderat
svært
ekstremt
moderat
svært
ekstremt
moderat
svært
ekstremt
moderat
svært
ekstremt
litt
moderat
svært
ekstremt
litt
moderat
svært
ekstremt
28. komme deg inn/ut av en bil?
ingen
litt
29. gå på handletur?
ingen
litt
30. ta på strømper?
ingen
litt
31. stå opp fra sengen?
ingen
litt
32. ta av strømper?
ingen
33. ligge i sengen?
ingen
34. komme deg inn/ut av dusj/badekar?
ingen
litt
moderat
svært
ekstremt
litt
moderat
svært
ekstremt
moderat
svært
ekstremt
litt
moderat
svært
ekstremt
litt
moderat
svært
ekstremt
35. sitte?
ingen
36. komme deg til toalettet?
ingen
litt
37. tungt husarbeid?
ingen
38. lett husarbeid?
ingen
5
I de neste 5 spørsmålene (EQ-5D-spørsmålene (http://www.euroqol.org) ønsker vi å vite
hvordan livssituasjonen din er:
39. Hvordan opplever du gangevnen din?
1
Jeg har ingen problemer med å gå omkring
2
Jeg har litt problemer med å gå omkring
3
Jeg er sengeliggende
40. Hvordan klarer du personlig stell?
1
Jeg har ingen problemer med personlig stell
2
Jeg har litt problemer med å vaske meg eller kle meg
3
Jeg klarer ikke å vaske meg eller kle meg
41. Hvordan klarer du dine vanlige gjøremål (f.eks. arbeid, studier, husarbeid, familie- og
fritidsaktiviteter)?
1
Jeg har ingen problemer med å utføre mine vanlige gjøremål
2
Jeg har litt problemer med å utføre mine vanlige gjøremål
3
Jeg er ute av stand til å utføre mine vanlige gjøremål
42. Smerter eller ubehag?
1
Jeg har verken smerte eller ubehag
2
Jeg har moderat smerte eller ubehag
3
Jeg har sterk smerte eller ubehag
43. Angst eller depresjon?
1
Jeg er verken engstelig eller deprimert
2
Jeg er noe engstelig eller deprimert
3
Jeg er svært engstelig eller deprimert
Mange takk for at du tok deg tid til å svare på spørreskjema!
Trude G. Lehmann
Cand.med
Lene B. Laborie
Cand.med
Karen Rosendahl
Seksjonsoverlege, Professor dr. med
Radiologisk avdeling
Ingvild Øvstebø Engesæter
Stud.med
Lars Birger Engesæter
Seksjonsoverlege, Professor dr. med
Barneortopedisk avdeling
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