Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 11/2017

01-11-2017 | Knee

The effects of a 3-month controlled hiking programme on the functional abilities of patients following total knee arthroplasty: a prospective, randomized trial

Authors: Caroline Hepperger, Peter Gföller, Christian Hoser, Hanno Ulmer, Felix Fischer, Wolfgang Schobersberger, Christian Fink

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 11/2017

Login to get access

Abstract

Purpose and hypothesis

Improvements in pain, function and sports activity are the main goals of patients following total knee arthroplasty (TKA). Participation in sports has become an increasingly important contributor to patients’ quality of life (QoL). Hiking is one of the most popular summer activities among elderly people in alpine regions. Consequently, this randomized controlled trial investigates the impact of a 3-month guided hiking programme on patients’ functional abilities and QoL following TKA. It was hypothesized that patients who participate in this programme would demonstrate improvements in functional and QoL parameters compared with a control group.

Methods

Forty-eight TKA patients were included and randomized into either the intervention group (IG; n = 25) or the control group (CG; n = 23). The IG participated in a 3-month hiking programme (2–3 times a week), whereas the CG performed activities of daily living. The stair climb test (SCT), QoL questionnaires and isokinetic force measurements were completed at three time points (i.e. pre-test, post-test, retention-test). ANOVAs for repeated measurements were conducted for the SCT results. The Friedman test and the Mann–Whitney U test were performed for the QoL parameters.

Results

After the 3-month hiking programme, the IG achieved faster overall walking times on the SCT. The time decreased from 4.3 ± 0.6 s (pre-test) to 3.6 ± 0.4 s (post-test) for the stair ascent (p = 0.060) and from 3.6 ± 0.6 s (pre-test) to 3.2 ± 0.5 s (post-test) for the stair descent (p = 0.036). The IG showed significant improvement on some of the subscales of the Knee Injury and Osteoarthritis Outcome Score from pre-test to retention-test (p < 0.01). In the CG, no significant changes were observed (n.s.).

Conclusions

The results indicate moderate improvement in the functional abilities and QoL of TKA patients who participated in a 3-month guided hiking programme compared with the patients in the CG. Hiking did not have any acute detrimental effects on the TKA patients during this study period.

Level of evidence

II.
Literature
1.
go back to reference Almeida GJ, Schroeder CA, Gil AB, Fitzgerald GK, Piva SR (2010) Interrater reliability and validity of the stair ascend/descend test in subjects with total knee arthroplasty. Arch Phys Med 91:932–938CrossRefPubMedPubMedCentral Almeida GJ, Schroeder CA, Gil AB, Fitzgerald GK, Piva SR (2010) Interrater reliability and validity of the stair ascend/descend test in subjects with total knee arthroplasty. Arch Phys Med 91:932–938CrossRefPubMedPubMedCentral
2.
go back to reference Amesberger G, Müller E, Würth S (2015) Alpine skiing with total knee arthroplasty (ASWAP): physical self-concept, pain, and life satisfaction. Scand J Med Sci Sports 25:82–89CrossRefPubMed Amesberger G, Müller E, Würth S (2015) Alpine skiing with total knee arthroplasty (ASWAP): physical self-concept, pain, and life satisfaction. Scand J Med Sci Sports 25:82–89CrossRefPubMed
3.
go back to reference Bauman S, Williams D, Petruccelli D, Elliott W, de Beer J (2007) Physical activity after total joint replacement: a cross-sectional survey. Clin J Sport Med 17:104–108CrossRefPubMed Bauman S, Williams D, Petruccelli D, Elliott W, de Beer J (2007) Physical activity after total joint replacement: a cross-sectional survey. Clin J Sport Med 17:104–108CrossRefPubMed
4.
go back to reference Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840PubMed Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840PubMed
5.
go back to reference Bellamy N, Campbell J, Stevens J, Pilch L, Stewart C, Mahmood Z (1997) Validation study of a computerized version of the Western Ontario and McMaster Universities VA3.0 Osteoarthritis index. J Rheumatol 24:2413–2415PubMed Bellamy N, Campbell J, Stevens J, Pilch L, Stewart C, Mahmood Z (1997) Validation study of a computerized version of the Western Ontario and McMaster Universities VA3.0 Osteoarthritis index. J Rheumatol 24:2413–2415PubMed
6.
go back to reference Bennell K, Dobson F, Hinman R (2011) Measures of physical performance assessments: self-paced walk test (SPWT), stair climb test (SCT), 6-m walk test (6MWT), chair stand test (CST), timed up & go (TUG), sock test, lift and carry test (LCT), and car task. Arthritis Care Res (Hoboken) 63:350–370CrossRef Bennell K, Dobson F, Hinman R (2011) Measures of physical performance assessments: self-paced walk test (SPWT), stair climb test (SCT), 6-m walk test (6MWT), chair stand test (CST), timed up & go (TUG), sock test, lift and carry test (LCT), and car task. Arthritis Care Res (Hoboken) 63:350–370CrossRef
7.
go back to reference Brazier JE, Harper R, Jones NM, O’Cathain A, Thomas KJ, Usherwood T, Westlake L (1992) Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ 305:160–164CrossRefPubMedPubMedCentral Brazier JE, Harper R, Jones NM, O’Cathain A, Thomas KJ, Usherwood T, Westlake L (1992) Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ 305:160–164CrossRefPubMedPubMedCentral
8.
go back to reference Bruyère O, Ethgen O, Neuprez A, Zègels B, Gillet P, Huskin JP, Reginster JY (2012) Health-related quality of life after total knee or hip replacement for osteoarthritis: a 7-year prospective study. Arch Orthop Trauma Surg 132:1583–1587CrossRefPubMed Bruyère O, Ethgen O, Neuprez A, Zègels B, Gillet P, Huskin JP, Reginster JY (2012) Health-related quality of life after total knee or hip replacement for osteoarthritis: a 7-year prospective study. Arch Orthop Trauma Surg 132:1583–1587CrossRefPubMed
10.
go back to reference Chang M, Kim S, Kang Y, Chang C, Kim T (2014) Activity levels and participation in physical activities by Korean patients following total knee arthroplasty. BMC Musculoskelet Disord 15:240CrossRefPubMedPubMedCentral Chang M, Kim S, Kang Y, Chang C, Kim T (2014) Activity levels and participation in physical activities by Korean patients following total knee arthroplasty. BMC Musculoskelet Disord 15:240CrossRefPubMedPubMedCentral
11.
go back to reference Chen L, Tan Y, Al-Aidaros M, Wang H, Wang X, Cai S (2013) Comparison of functional performance after total knee arthroplasty using rotating platform and fixed-bearing prostheses with or without patellar resurfacing. Orthop Surg 5:112–117CrossRefPubMed Chen L, Tan Y, Al-Aidaros M, Wang H, Wang X, Cai S (2013) Comparison of functional performance after total knee arthroplasty using rotating platform and fixed-bearing prostheses with or without patellar resurfacing. Orthop Surg 5:112–117CrossRefPubMed
12.
go back to reference Dahm DL, Barnes SA, Harrington JR, Sayeed SA, Berry DJ (2008) Patient-reported activity level after total knee arthroplasty. J Arthroplasty 23:401–407CrossRefPubMed Dahm DL, Barnes SA, Harrington JR, Sayeed SA, Berry DJ (2008) Patient-reported activity level after total knee arthroplasty. J Arthroplasty 23:401–407CrossRefPubMed
13.
go back to reference Ethgen O, Bruyère O, Richy F, Dardennes C, Reginster JY (2004) Health-related quality of life in total hip and total knee arthroplasty: a qualitative and systematic review of the literature. J Bone Joint Surg Am 86:963–974CrossRefPubMed Ethgen O, Bruyère O, Richy F, Dardennes C, Reginster JY (2004) Health-related quality of life in total hip and total knee arthroplasty: a qualitative and systematic review of the literature. J Bone Joint Surg Am 86:963–974CrossRefPubMed
14.
go back to reference Gandhi R, Dhotar H, Razak F, Tso P, Davey JR, Mahomed NN (2010) Predicting the longer term outcomes of total knee arthroplasty. Knee 17:15–18CrossRefPubMed Gandhi R, Dhotar H, Razak F, Tso P, Davey JR, Mahomed NN (2010) Predicting the longer term outcomes of total knee arthroplasty. Knee 17:15–18CrossRefPubMed
15.
go back to reference Hamai S, Miura H, Higaki H, Shimoto T, Matsuda S, Okazaki K, Iwamoto Y (2008) Three-dimensional knee joint kinematics during golf swing and stationary cycling after total knee arthroplasty. J Orthop Res 26:1556–1561CrossRefPubMed Hamai S, Miura H, Higaki H, Shimoto T, Matsuda S, Okazaki K, Iwamoto Y (2008) Three-dimensional knee joint kinematics during golf swing and stationary cycling after total knee arthroplasty. J Orthop Res 26:1556–1561CrossRefPubMed
16.
go back to reference Healy WL, Sharma S, Schwartz B, Iorio R (2008) Athletic activity after total joint arthroplasty. J Bone Joint Surg Am 90:2245–2252CrossRefPubMed Healy WL, Sharma S, Schwartz B, Iorio R (2008) Athletic activity after total joint arthroplasty. J Bone Joint Surg Am 90:2245–2252CrossRefPubMed
17.
go back to reference Hepperger C, Abermann E, Herbst E, Hoser C, Gföller P, Fink C (2016) Free papers. Knee Surg Sports Traumatol Arthrosc 24(Suppl 1):S4–S114 Hepperger C, Abermann E, Herbst E, Hoser C, Gföller P, Fink C (2016) Free papers. Knee Surg Sports Traumatol Arthrosc 24(Suppl 1):S4–S114
18.
go back to reference Hofstaedter T, Fink C, Dorn U, Pötzelsberger B, Hepperger C, Gordon K, Müller E (2015) Alpine skiing with total knee arthroplasty (ASWAP): clinical and radiographic outcomes. Scand J Med Sci Sports 25:10–15CrossRefPubMed Hofstaedter T, Fink C, Dorn U, Pötzelsberger B, Hepperger C, Gordon K, Müller E (2015) Alpine skiing with total knee arthroplasty (ASWAP): clinical and radiographic outcomes. Scand J Med Sci Sports 25:10–15CrossRefPubMed
19.
go back to reference Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14 Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14
20.
go back to reference Jones DL, Cauley JA, Kriska AM, Wisniewski SR, Irrgang JJ, Heck DA, Kwoh CK, Crossett LS (2004) Physical activity and risk of revision total knee arthroplasty in individuals with knee osteoarthritis: a matched case–control study. J Rheumatol 31:1384–1390PubMed Jones DL, Cauley JA, Kriska AM, Wisniewski SR, Irrgang JJ, Heck DA, Kwoh CK, Crossett LS (2004) Physical activity and risk of revision total knee arthroplasty in individuals with knee osteoarthritis: a matched case–control study. J Rheumatol 31:1384–1390PubMed
21.
go back to reference Kösters A, Pötzelsberger B, Dela F, Dorn U, Hofstaedter T, Fink C, Müller E (2015) Alpine skiing with total knee arthroplasty (ASWAP): study design and intervention. Scand J Med Sci Sports 25:3–9CrossRefPubMed Kösters A, Pötzelsberger B, Dela F, Dorn U, Hofstaedter T, Fink C, Müller E (2015) Alpine skiing with total knee arthroplasty (ASWAP): study design and intervention. Scand J Med Sci Sports 25:3–9CrossRefPubMed
22.
go back to reference Kuster MS, Grob K, Gachter A (2000) Problems of total knee replacement from a sports orthopedics point of view. Orthopade 29:739–745CrossRefPubMed Kuster MS, Grob K, Gachter A (2000) Problems of total knee replacement from a sports orthopedics point of view. Orthopade 29:739–745CrossRefPubMed
23.
go back to reference Kuster MS, Grob K, Gachter A (2000) Knee endoprosthesis: sports orthopedics possibilities and limitations. Orthopade 29:739–745CrossRefPubMed Kuster MS, Grob K, Gachter A (2000) Knee endoprosthesis: sports orthopedics possibilities and limitations. Orthopade 29:739–745CrossRefPubMed
24.
go back to reference Lavernia CJ, Sierra RJ, Hungerford DS, Krackow K (2001) Activity level and wear in total knee arthroplasty: a study of autopsy retrieved specimens. J Arthroplasty 16:446–453CrossRefPubMed Lavernia CJ, Sierra RJ, Hungerford DS, Krackow K (2001) Activity level and wear in total knee arthroplasty: a study of autopsy retrieved specimens. J Arthroplasty 16:446–453CrossRefPubMed
25.
go back to reference Lee WC, Kwan YH, Chong HC, Yeo SJ (2016) The minimal clinically important difference for Knee Society Clinical Rating System after total knee arthroplasty for primary osteoarthritis. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-016-4208-9 Lee WC, Kwan YH, Chong HC, Yeo SJ (2016) The minimal clinically important difference for Knee Society Clinical Rating System after total knee arthroplasty for primary osteoarthritis. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-016-4208-9
26.
go back to reference Liebensteiner MC, Krismer M, Koller A, Semenitz B, Mayr E (2012) Does minimally invasive total knee arthroplasty improve isokinetic torque? Clin Orthop Relat Res 470:3233–3239CrossRefPubMedPubMedCentral Liebensteiner MC, Krismer M, Koller A, Semenitz B, Mayr E (2012) Does minimally invasive total knee arthroplasty improve isokinetic torque? Clin Orthop Relat Res 470:3233–3239CrossRefPubMedPubMedCentral
27.
go back to reference Marques EA, Mota J, Carvalho J (2012) Exercise effects on bone mineral density in older adults: a meta-analysis of randomized controlled trials. Age (Dordr) 34:1493–1515CrossRef Marques EA, Mota J, Carvalho J (2012) Exercise effects on bone mineral density in older adults: a meta-analysis of randomized controlled trials. Age (Dordr) 34:1493–1515CrossRef
28.
go back to reference Mayr HO, Reinhold M, Bernstein A, Suedkamp NP, Stoehr A (2015) Sports activity following total knee arthroplasty in patients older than 60 years. J Arthroplasty 30:46–49CrossRefPubMed Mayr HO, Reinhold M, Bernstein A, Suedkamp NP, Stoehr A (2015) Sports activity following total knee arthroplasty in patients older than 60 years. J Arthroplasty 30:46–49CrossRefPubMed
29.
go back to reference McGrory BJ, Stuart MJ, Sim FH (1995) Participation in sports after hip and knee arthroplasty: review of literature and survey of surgeon preferences. Mayo Clin Proc 70:342–348CrossRefPubMed McGrory BJ, Stuart MJ, Sim FH (1995) Participation in sports after hip and knee arthroplasty: review of literature and survey of surgeon preferences. Mayo Clin Proc 70:342–348CrossRefPubMed
30.
go back to reference Mont MA, Marker DR, Seyler TM, Gordon N, Hungerford DS, Jones LC (2007) Knee arthroplasties have similar results in high- and low-activity patients. Clin Orthop Relat Res 460:165–173PubMed Mont MA, Marker DR, Seyler TM, Gordon N, Hungerford DS, Jones LC (2007) Knee arthroplasties have similar results in high- and low-activity patients. Clin Orthop Relat Res 460:165–173PubMed
31.
go back to reference Mont MA, Marker DR, Seyler TM, Jones LC, Kolisek FR, Hungerford DS (2008) High-impact sports after total knee arthroplasty. J Arthroplasty 23(Suppl1):80–84CrossRefPubMed Mont MA, Marker DR, Seyler TM, Jones LC, Kolisek FR, Hungerford DS (2008) High-impact sports after total knee arthroplasty. J Arthroplasty 23(Suppl1):80–84CrossRefPubMed
32.
go back to reference Nilsdotter A, Toksvig-Larsen S, Roos EM, Nilsdotteryz A, Rooszx EM (2009) A 5 year prospective study of patient-relevant outcomes after total knee replacement. Osteoarthr Cartil 17:601–606CrossRefPubMed Nilsdotter A, Toksvig-Larsen S, Roos EM, Nilsdotteryz A, Rooszx EM (2009) A 5 year prospective study of patient-relevant outcomes after total knee replacement. Osteoarthr Cartil 17:601–606CrossRefPubMed
33.
go back to reference Núñez M, Núñez E, Luis del Val J, Ortega R, Segur JM, Hernández MV, Lozano L, Sastre S, Maculé F (2007) Health-related quality of life in patients with osteoarthritis after total knee replacement: factors influencing outcomes at 36 months of follow-up. Osteoarthr Cartil 15:1001–1007CrossRefPubMed Núñez M, Núñez E, Luis del Val J, Ortega R, Segur JM, Hernández MV, Lozano L, Sastre S, Maculé F (2007) Health-related quality of life in patients with osteoarthritis after total knee replacement: factors influencing outcomes at 36 months of follow-up. Osteoarthr Cartil 15:1001–1007CrossRefPubMed
34.
go back to reference Pötzelsberger B, Lindinger SJ, Stöggl T, Buchecker M, Müller E (2015) Alpine skiing with total knee arthroplasty (ASWAP): effects on gait asymmetries. Scand J Med Sci Sports 25:49–59CrossRefPubMed Pötzelsberger B, Lindinger SJ, Stöggl T, Buchecker M, Müller E (2015) Alpine skiing with total knee arthroplasty (ASWAP): effects on gait asymmetries. Scand J Med Sci Sports 25:49–59CrossRefPubMed
35.
go back to reference Pötzelsberger B, Stöggl T, Lindinger SJ, Dirnberger J, Stadlmann M, Buchecker M, Hofstaedter T, Gordon K, Müller E (2015) Alpine skiing with total knee arthroplasty (ASWAP): effects on strength and cardiorespiratory fitness. Scand J Med Sci Sports 25:16–25CrossRefPubMed Pötzelsberger B, Stöggl T, Lindinger SJ, Dirnberger J, Stadlmann M, Buchecker M, Hofstaedter T, Gordon K, Müller E (2015) Alpine skiing with total knee arthroplasty (ASWAP): effects on strength and cardiorespiratory fitness. Scand J Med Sci Sports 25:16–25CrossRefPubMed
36.
go back to reference Rejeski WJ, Ettinger WH, Schumaker S, James P, Burns R, Elam JT (1995) Assessing performance-related disability in patients with knee osteoarthritis. Osteoarthr Cartil 3:157–167CrossRefPubMed Rejeski WJ, Ettinger WH, Schumaker S, James P, Burns R, Elam JT (1995) Assessing performance-related disability in patients with knee osteoarthritis. Osteoarthr Cartil 3:157–167CrossRefPubMed
37.
go back to reference Roos EM, Lohmander LS (2003) The Knee injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes 1:64CrossRefPubMedPubMedCentral Roos EM, Lohmander LS (2003) The Knee injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes 1:64CrossRefPubMedPubMedCentral
38.
go back to reference Roos EM, Roos HP, Ekdahl C, Lohmander LS (1998) Knee injury and Osteoarthritis Outcome Score (KOOS)—validation of a Swedish version. Scand J Med Sci Sports 8:439–448CrossRefPubMed Roos EM, Roos HP, Ekdahl C, Lohmander LS (1998) Knee injury and Osteoarthritis Outcome Score (KOOS)—validation of a Swedish version. Scand J Med Sci Sports 8:439–448CrossRefPubMed
39.
go back to reference Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD (1998) Knee Injury and Osteoarthritis Outcome Score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther 28:88–96CrossRefPubMed Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD (1998) Knee Injury and Osteoarthritis Outcome Score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther 28:88–96CrossRefPubMed
40.
go back to reference Roos EM, Toksvig-Larsen S (2003) Knee injury and Osteoarthritis Outcome Score (KOOS)—validation and comparison to the WOMAC in total knee replacement. Health Qual Life Outcomes 1:17CrossRefPubMedPubMedCentral Roos EM, Toksvig-Larsen S (2003) Knee injury and Osteoarthritis Outcome Score (KOOS)—validation and comparison to the WOMAC in total knee replacement. Health Qual Life Outcomes 1:17CrossRefPubMedPubMedCentral
41.
go back to reference Schmalzried TP, Szuszczewicz ES, Northfield MR, Akizuki KH, Frankel RE, Belcher G, Amstutz HC (1998) Quantitative assessment of walking activity after total hip or knee replacement. J Bone Joint Surg Am 80:54–59CrossRefPubMed Schmalzried TP, Szuszczewicz ES, Northfield MR, Akizuki KH, Frankel RE, Belcher G, Amstutz HC (1998) Quantitative assessment of walking activity after total hip or knee replacement. J Bone Joint Surg Am 80:54–59CrossRefPubMed
42.
go back to reference Swanson EA, Schmalzried TP, Dorey FJ (2009) Activity recommendations after total hip and knee arthroplasty: a survey of the American Association for Hip and Knee Surgeons. J Arthroplasty 24:120–126CrossRefPubMed Swanson EA, Schmalzried TP, Dorey FJ (2009) Activity recommendations after total hip and knee arthroplasty: a survey of the American Association for Hip and Knee Surgeons. J Arthroplasty 24:120–126CrossRefPubMed
44.
go back to reference Ware JE, Gandek B (1998) Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. J Clin Epidemiol 51:903–912CrossRefPubMed Ware JE, Gandek B (1998) Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. J Clin Epidemiol 51:903–912CrossRefPubMed
45.
go back to reference Ware JE, Sherbourne CD (1992) The MOS 36-ltem Short-Form Health Survey (SF-36): I. Conceptual framework and item selection. Med Care 30:473–483CrossRefPubMed Ware JE, Sherbourne CD (1992) The MOS 36-ltem Short-Form Health Survey (SF-36): I. Conceptual framework and item selection. Med Care 30:473–483CrossRefPubMed
46.
go back to reference Weiss JM, Noble PC, Conditt MA, Kohl HW, Roberts S, Cook KF, Gordon MJ, Mathis KB (2002) What functional activities are important to patients with knee replacements? Clin Orthop Relat Res 404:172–188CrossRef Weiss JM, Noble PC, Conditt MA, Kohl HW, Roberts S, Cook KF, Gordon MJ, Mathis KB (2002) What functional activities are important to patients with knee replacements? Clin Orthop Relat Res 404:172–188CrossRef
47.
go back to reference Würth S, Finkenzeller T, Pötzelsberger B, Müller E, Amesberger G (2015) Alpine skiing with total knee arthroplasty (ASWAP): physical activity, knee function, pain, exertion, and well-being. Scand J Med Sci Sports 25:74–81CrossRefPubMed Würth S, Finkenzeller T, Pötzelsberger B, Müller E, Amesberger G (2015) Alpine skiing with total knee arthroplasty (ASWAP): physical activity, knee function, pain, exertion, and well-being. Scand J Med Sci Sports 25:74–81CrossRefPubMed
Metadata
Title
The effects of a 3-month controlled hiking programme on the functional abilities of patients following total knee arthroplasty: a prospective, randomized trial
Authors
Caroline Hepperger
Peter Gföller
Christian Hoser
Hanno Ulmer
Felix Fischer
Wolfgang Schobersberger
Christian Fink
Publication date
01-11-2017
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 11/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-016-4299-3

Other articles of this Issue 11/2017

Knee Surgery, Sports Traumatology, Arthroscopy 11/2017 Go to the issue