[Workplace Interventions to Reduce Sedentary Behavior: A Systematic Review]. / Interventionen zur Reduzierung sitzenden Verhaltens am Büroarbeitsplatz ­ eine systematische Literaturanalyse.

BACKGROUND: Sedentary behaviour is a health risk factor independent of physical activity. Interventions that aim to reduce sitting at the workplace are particularly important as office workers spend a large proportion of their working hours sitting. This systematic review examines whether these interventions (SB or PA interventions during work time) reduce sitting time among office workers and which variables moderate intervention effects. METHODS: A systematic literature search was conducted from April to May 2016 in the following databases: PubMed, PsycINFO and SPORTDiscus. In total, we identified 17 studies that assessed the time spent in sedentary behaviour at the office workplace. To summarize the study results, we applied a best-evidence synthesis. Additionally, we evaluated potential moderators, such as intervention strategies. RESULTS: Multi-component interventions and sit-stand workstations were most promising sedentary reduction interventions. The analysis of moderators highlighted that the proportion of positive intervention effects was higher in interventions based on the strategies "environmental restructuring", "adding objects to the environment" and "instructions on how to carry out the behaviour". Furthermore, interventions focusing on sedentary behaviour only and studies using objective measurement tools showed more often positive interventions effects. CONCLUSIONS: There are many promising interventions to reduce sitting time at the office workplace. However, there is insufficient evidence if the effects of these interventions are sustainable in the long term. Moreover, the considerable heterogeneity of included studies limits the validity of our findings. Future intervention studies should build on a theoretical planning approach and use subjective as well as objective evaluation measures.

Femoral Head Avascular Necrosis Is Not Caused by Arthroscopic Posterolateral Femoroplasty.

This study was conducted to identify the risk of avascular necrosis of the femoral head after arthroscopic femoroplasty extending to the posterolateral femoral neck, the source of the primary blood supply to the femoral head. Cam lesions of femoroacetabular impingement are typically anterior along the junction of the femoral head and neck. However, anatomic variations can involve the posterolateral vascular region of the femoral head and neck. Femoroplasty involving this vascular region can lead to injury to the blood supply to the femoral head, with subsequent avascular necrosis. If the posterolateral portion of the cam lesion is preserved, persistent femoroacetabular impingement may occur. A retrospective review identified 112 patients who underwent arthroscopic femoroplasty for femoroacetabular impingement over a 2-year period. Of these patients, 14 had femoroplasty that extended to the posterolateral femoral head. Of this group, 5 had undergone magnetic resonance imaging (MRI) after femoroplasty and the other 9 were contacted to undergo MRI of the hip to evaluate for avascular necrosis. A radiologist and the senior author evaluated all MRI scans specifically for avascular necrosis of the femoral head. All procedures were performed by the senior author. Mean age of the 14 patients (8 women and 6 men) with femoroplasty that extended into the posterolateral vascular region of the femoral head was 44 years (range, 23-69 years). All 14 patients underwent MRI evaluation of the affected hip a mean of 25 months (range, 7-44 months) after femoroplasty. No MRI scans showed evidence of avascular necrosis of the femoral head. Femoroplasty of the posterolateral vascular region of the femoral head is not associated with avascular necrosis. Patients with femoroacetabular impingement and a cam lesion extending to the posterolateral femoral head can undergo femoroplasty of this region without the development of avascular necrosis. [Orthopedics. 2016; 39(3):177-180.].

Peripheral versus central compartment starting point in hip arthroscopy for femoroacetabular impingement.

The purpose of this study was to compare the perioperative complications and traction times in femoroacetabular impingement hip arthroscopy with either a peripheral or central compartment starting point. Sixty patients with femoroacetabular impingement were treated with hip arthroscopy. Thirty patients had a peripheral compartment starting point and 30 had a central compartment starting point. Intra- and postoperative complications were documented along with traction times. The peripheral compartment starting group experienced 6 minor chondral injuries and 1 case of postoperative paresthesias. The central compartment starting group experienced 8 minor and 3 moderate chondral injuries, 2 labral penetrations, and 3 cases of postoperative paresthesias. Traction time averaged 46 minutes in the peripheral compartment starting group and 73 minutes in the central compartment starting group. Iatrogenic injury and traction times are decreased with peripheral vs central compartment starting in hip arthroscopy for femoroacetabular impingement. Consideration should be given for peripheral compartment starting in hip arthroscopy for the treatment of femoroacetabular impingement.