Der Orthopäde
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As a consequence of limited personnel and financial resources, the increase in total hip arthroplasties places higher demands on orthopedic surgeons. ⋯ These results underline the recommendations of the German Endocert system, which determine a minimum number of total joint arthroplasties as a quality indicator not only for hospitals but also for individual surgeons.
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The international strategies in the treatment of rheumatic diseases have changed dramatically in the last 10 years. In addition to the prescription of a basic medication as soon as possible, biologics are increasingly being used for drug treatment of rheumatic diseases in Germany. The domains of orthopedic surgeons and orthopedic rheumatologists are still the extended conservative and surgical treatment of inflammatory systemic diseases, which continue to play an important role despite the improved drug therapy options. ⋯ However, there is also a role for the orthopedic surgeon in the early detection of inflammatory systemic diseases and in cooperation with rheumatologists in the medicinal treatment of selected diseases. Because patients with initial stages of joint pain, e.g. from rheumatoid arthritis (RA), spondyloarthritis (SpA) or psoriatic arthropathy often present first to an orthopedic surgeon, recognition of the early stages by the primary treating physician, including the necessary rapid induction of drug therapy is especially important. In addition there is a shortage of internist rheumatologists in Germany so that selective referral and close cooperation between the two physicians become of great importance.