Operative Orthopadie Und Traumatologie最新文献

{"title":"[Support bandages: properties of support bandage materials and biomechanical properties].","authors":"Klaus Dresing, Theddy F Slongo","doi":"10.1007/s00064-025-00895-9","DOIUrl":"10.1007/s00064-025-00895-9","url":null,"abstract":"<p><p>Support bandages and casts are used to immobilize and stabilize limbs after various types of injuries that require appropriate immobilization. Depending on the type of injury, different types of support bandages/casts and different materials are used. Due to the increasing surgical treatment of fractures in children, we are observing a decline in the practical skills needed to properly apply supportive bandages, particularly plaster casts. In the following, the different materials of support bandages and their properties are presented as well as their corresponding indications.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"266-275"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical treatment of unstable and displaced medial clavicle fractures with a contoured biplanar low profile angle stable implant.","authors":"J Schmalzl, J Zimmermann, L Hufnagel, R Meffert","doi":"10.1007/s00064-025-00901-0","DOIUrl":"https://doi.org/10.1007/s00064-025-00901-0","url":null,"abstract":"<p><strong>Objective: </strong>To achieve stable fixation to allow early mobilization by using a low profile contoured biplanar implant to avoid soft tissue problems and to minimize need for implant removal.</p><p><strong>Indications: </strong>Unstable and displaced medial clavicle fractures in young patients with high functional demands.</p><p><strong>Contraindications: </strong>Open/contaminated fractures. Fractures in geriatric patients with low functional demands.</p><p><strong>Surgical technique: </strong>Saber cut incision over the medial clavicle. Perpendicular incision to open the calvipectoral fascia. Fracture reduction and temporary retention. Contouring and attachment of the plate. Definitive plate fixation. Radiological documentation.</p><p><strong>Postoperative management: </strong>Cryotherapy, anti-inflammatory medication on demand. Shoulder sling for comfort for 1-2 weeks. Physical therapy with active flexion and abduction limited to 90° for 6 weeks. Clinical and radiological follow up for 6-12 months.</p><p><strong>Results: </strong>In total, 5 patients were treated with the described technique. All patients were very satisfied with the result. The mean Constant-Murley score was 91 points and the mean Quick DASH (disabilities of shoulder and hand) was 3% after an average follow-up of 74 months. In none of the cases implant removal was necessary.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Arthroscopic cartilage surgery of the ankle : Chondroplasty, retrograde drilling, nano-/microfracture].","authors":"O Gottschalk, A Röser, H Hörterer, A Mehlhorn, L Deiß, M Walther","doi":"10.1007/s00064-025-00904-x","DOIUrl":"https://doi.org/10.1007/s00064-025-00904-x","url":null,"abstract":"<p><strong>Objective: </strong>Repair of the cartilage surface to prevent progression of cartilage pathologies that are associated with pain and limited mobility.</p><p><strong>Indications: </strong>Talar cartilage lesions up to 1 cm².</p><p><strong>Contraindications: </strong>Joint infection, generalized arthritis, poor compliance.</p><p><strong>Surgical technique: </strong>If the cartilage layer is arthroscopically intact: retrograde drilling to increase blood flow and decompress a bone marrow edema or cyst. Superficial cartilage damage: chondroplasty and surface smoothing to limit loose bodies or damage progression. Deep cartilage damage down to the subchondral plate: nano- or microfracture with surface growth cell protrusion to gain replacement cartilage.</p><p><strong>Postoperative management: </strong>For primary smoothing of the cartilage surface, immobilization with partial loading is recommended until proper wound healing. However, if there is cartilage damage that requires replacement cartilage to form, prolonged partial loading for up to 6 weeks, followed by increased loading is required.</p><p><strong>Results: </strong>Chondroplasty is usually used in combination with other treatment steps, so few results are available for this treatment alone. Retrograde drilling shows good results in young patients with still open growth plates. Furthermore, a recurrence rate of up to 50% can occur. Nano- or microfracture shows good to excellent results for lesions up to 1 cm². For larger lesions this procedure alone appears to be insufficient.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined direct anterior approach and navigation-assisted percutaneous anterograde posterior column fixation for acetabular periprosthetic fractures.","authors":"Gautier Beckers, Dominic Simon, Maximilian Lerchenberger, Wolfgang Böcker, Jörg Arnholdt, Boris M Holzapfel","doi":"10.1007/s00064-025-00900-1","DOIUrl":"https://doi.org/10.1007/s00064-025-00900-1","url":null,"abstract":"<p><strong>Objective: </strong>Management of acetabular periprosthetic fractures using a combined direct anterior approach (DAA) with or without proximal intrapelvic Levine extension and navigation-assisted percutaneous anterograde posterior column screw fixation.</p><p><strong>Indications: </strong>Acute and subacute non-displaced or minimally displaced periprosthetic posterior column fracture, pathological fracture, or osteolysis of the posterior column.</p><p><strong>Contraindications: </strong>Highly displaced posterior column, and/or comminuted fractures, narrow osseous corridor, large abdominal pannus, and inguinal skin infection.</p><p><strong>Surgical technique: </strong>A classic DAA approach with or without proximal extension is performed, as for acetabular revisions. The hip is then dislocated, and both the femoral head and insert are extracted. The stability of the acetabular component is assessed. If it is found to be loose, the acetabular component is removed, and the fracture line is evaluated. Following this step, if criteria for anterograde percutaneous screw fixation are met, a minimally invasive stab incision over the iliac crest is performed. After calibration of the navigation system and 3D computed tomography (CT) data acquisition, the fascia is sharply opened, and blunt dissection of the iliac muscle is performed using a Cobb elevator under hip flexion to protect the femoral nerve and iliac muscle. After defining the trajectory in three planes using the navigation system, pre-drilling is performed with a 2.8-mm K-wire. Subsequently, a 7.5-mm fully threaded screw is inserted, and intraoperative CT is repeated to verify the correct screw position. The procedure is then completed by replacing the acetabular component via the DAA if it was loose. Additional screw fixation through the acetabular implant is advised.</p><p><strong>Results: </strong>Based on our preliminary experience, this technique offers a safe alternative with favorable outcomes compared to combined anterior and posterior approaches. It diminishes soft tissue trauma and procedural complexity while retaining the advantages of the anterior approach. The utilization of navigation allows for precise screw positioning and enhances surgical accuracy. Consequently, this surgical technique enables the increasing number of DAA surgeons to address rare complications using their preferred approach.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Arthroscopically assisted arthrodesis of the upper ankle joint].","authors":"Annette Eidmann, Katharina Kraftborn, Matthias G Walcher, Lukas Fraißler, Maximilian Rudert, Ioannis Stratos","doi":"10.1007/s00064-025-00899-5","DOIUrl":"https://doi.org/10.1007/s00064-025-00899-5","url":null,"abstract":"<p><strong>Objective: </strong>To obtain a pain-free, fully weight-bearing ankle joint in a functional position through minimally invasive arthrodesis.</p><p><strong>Indications: </strong>Symptomatic osteoarthritis of the upper ankle joint, which is no longer treatable conservatively or by joint-preserving surgical procedures.</p><p><strong>Contraindications: </strong>Revision arthrodesis, infections in the surgical area, circulatory disorders; extensive malalignment, large bony defects (relative contraindications).</p><p><strong>Surgical technique: </strong>Anteromedial and anterolateral standard portal to the upper ankle joint. Soft tissue debridement and, if necessary, removal of large ventral osteophytes and free joint bodies. Removal of the remaining tibiotalar articular cartilage using curettes, sharp spoons, chisels, or reamers. Opening of the subchondral bone with bone awls or chisels to expose the former joint surfaces. Anatomical adjustment of the joint, transfixation with 2 to 3 Kirschner wires for percutaneous stabilization with cannulated double-threaded screws or cancellous bone screws with short threads under X‑ray control.</p><p><strong>Postoperative management: </strong>Postoperative immobilization in an orthosis or plaster cast with unloading for 6 weeks; after X‑ray control, gradual increase in weight-bearing over a further 2-6 weeks.</p><p><strong>Results: </strong>In all, 30 arthroscopically assisted arthrodeses of the ankle joint performed between 2014 and 2017 were retrospectively evaluated. Of these, 22 patients were very satisfied, 5 patients were satisfied, and only 2 patients were not satisfied with the surgical outcome. The evaluation using postoperative scores (American Orthopaedic Foot and Ankle Society Score [AOFAS], Foot and Ankle Outcome Score [FAOS], Visual Analogue Scale Foot and Ankle [VAS-FA]) also yielded good results on average. The complication rates were comparable to those in the literature, with 2 pseudarthroses, 3 superficial wound healing disorders, and 2 irritations caused by the osteosynthesis material.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Treatment with TOPS for short femoral stump].","authors":"Marko Saß, Horst Heinrich Aschoff, Thomas Mittlmeier","doi":"10.1007/s00064-024-00885-3","DOIUrl":"10.1007/s00064-024-00885-3","url":null,"abstract":"<p><strong>Objective: </strong>Treatment with transcutaneous osseointegrated prosthesis systems (TOPS) for short femoral amputation stumps aims to restore independent walking ability after proximal femoral amputation by direct bone-guided prosthesis anchorage. This cannot be safely achieved with conventional socket prostheses due to the mechanically inadequate socket contact surface.</p><p><strong>Indications: </strong>Treatment of patients with short transfemoral stumps who cannot be mobilized sufficiently with conventional socket prostheses.</p><p><strong>Contraindications: </strong>Known contraindications as with standard TOPS fittings.</p><p><strong>Surgical technique: </strong>Special features already arise during positioning with correct orthograde adjustment of the short femoral stump under X‑ray fluoroscopy. The prosthesis is anchored using the specified technique, taking into account the central insertion of the femoral neck screw with the aid of the aiming arm under X‑ray fluoroscopy in two planes.</p><p><strong>Postoperative management: </strong>In most cases, step 1 and 2 treatment is primarily possible, i.e., insertion of the double-cone adapter and passing through the skin by the intraoperatively created stoma (skin opening on the amputation stump). This requires patient compliance and hygiene with twice daily showering of the stoma and dressing. After the exoprosthesis components have been fitted by the patient's orthopedic technician, weight-bearing with the new adapted prosthesis is possible.</p><p><strong>Results: </strong>A total of 14 TOPS procedures were performed at Rostock University Medical Center between 2022 and 2024, including 9 patients with short femoral stumps. A prolonged rehabilitation phase compared to patients with \"standard\" TOPS restorations is not recognizable, but a significant gain in quality of life is evident.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"114-123"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Reconstruction of the patellar tendon with autologous or allogeneic semitendinosus tendon transplant for chronic rupture].","authors":"Wolf Petersen, Hasan Al Mustafa, Martin Häner, Karl Braun","doi":"10.1007/s00064-024-00859-5","DOIUrl":"10.1007/s00064-024-00859-5","url":null,"abstract":"<p><strong>Objective: </strong>Reconstruction of a patellar tendon defect in the event of a chronic rupture.</p><p><strong>Indications: </strong>Chronic rupture of the patellar tendon due to delayed diagnosis or failure of primary refixation with a dehiscence that does not allow for anatomical refixation without patellar tendon shortening.</p><p><strong>Contraindications: </strong>Infection.</p><p><strong>Surgical technique: </strong>Approximately 15 cm long incision from the tibial tuberosity to the patella. Depicting the rupture. Debridement of the tendon and insertion. Suture in the quadriceps tendon and distalization of the patella. If sufficient distalization of the patella is not possible, optionally perform a VY-plasty of the quadriceps tendon. Measuring the dehiscence. Securing the height of the patella by applying a patellotibial cerclage (strong suture cord). Extension of an existing tendon stump using a Z-plasty. Creation of 2 bone tunnels (diameter approx. 5 mm) in the patella and the tibial tuberosity. Insertion of an autologous or allogeneic semitendinosus tendon transplant and securing it by knotting the retaining threads in front of the tibial tuberosity.</p><p><strong>Postoperative management: </strong>Six weeks of partial weight-bearing with 10 kg of body weight in a straight, removable splint. Range of movement: weeks 1-4 E/F 0-0-60°, weeks 5-6 E/F 0-0-90°.</p><p><strong>Results: </strong>Seven patients who underwent this surgery as described above had a minimum follow-up of 2 years. Secondary lengthening of the quadriceps tendon had to be performed twice due to excessive retraction. All patients were able to perform active extension postoperatively. The Lysholm score rose from 49.3 to 83.2 points. No further rupture was detectable in the final ultrasound examination.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"150-158"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Treatment of diametaphyseal forearm fractures in children and adolescents : Antegrade intramedullary nail osteosynthesis and its alternatives].","authors":"H Rüther, C Spering, L Fortini, K Dresing, W Lehmann, T Radebold","doi":"10.1007/s00064-024-00877-3","DOIUrl":"10.1007/s00064-024-00877-3","url":null,"abstract":"<p><strong>Objective: </strong>Osteosynthesis in dislocated diametaphyseal forearm fractures is intended to restore anatomy and function. Antegrade intramedullary nailing in the radius is used to restore length, rotation, and axis within the age-specific correction limits. Sufficient stability ensures early functional postoperative treatment without load.</p><p><strong>Indications: </strong>Dislocated diametaphyseal forearm or radius fractures that cannot be closed, stably reduced, or remain outside the age-specific correction limits.</p><p><strong>Contraindications: </strong>Radius or forearm fractures located distal or proximal to the defined area. Soft tissue defects, contamination or infections located in the access path.</p><p><strong>Surgical technique: </strong>In the course of the Thompson approach, the soft spot between the extensor digitorum and extensor carpi radialis brevis muscles is located and an approx. 3-4 cm skin incision is made. Then blunt preparation down to the bone, sparing the profundus and superficial radial nerve. Retraction of the musculature with two Langenbeck hooks. Opening of the cortex with an awl. If necessary, a 2.5 mm drill with tissue protection can be used beforehand if the cortex is very hard. A titanium elastic nail (TEN) diameter is selected so that it fills approximately 2/3 of the medullary canal. It is recommended to flatten the TEN runner with parallel flattening forceps. After closed reduction, the TEN is then brought up in front of the growth plate with slightly rotating movements. The TEN is bent over at the proximal end and pinched off above the muscle bellies. Alternative procedures include Kirschner wire osteosynthesis or retrograde TEN from radial or dorsal, with or without bending.</p><p><strong>Postoperative management: </strong>The aim of osteosynthesis is early functional follow-up without load. Sports abstinence is recommended for 8 weeks. Metal removal can be performed after consolidation between 3 and 6 months.</p><p><strong>Results: </strong>Clearly dislocated or outside the correction limits infantile radius and forearm fractures show very good treatment results with a low risk profile after the described osteosynthesis technique. Pseudarthrosis and nerve damage were not observed. Secondary dislocation has not occurred.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"159-170"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11958432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical technique of a bone-anchored prosthesis for transhumeral amputees.","authors":"Jan Paul Frölke, Horst Aschoff, Henk Van de Meent, Thomas Mittlmeier","doi":"10.1007/s00064-025-00894-w","DOIUrl":"10.1007/s00064-025-00894-w","url":null,"abstract":"<p><strong>Objective: </strong>Fixating an arm prosthesis with a transcutaneous bone anchor provides a more comfortable and stable attachment than conventional socket-attached prosthetics. The objective is that bone anchoring will improve prosthetic usage, reduce prosthesis rejection, and aid to functions in daily life activities.</p><p><strong>Indications: </strong>Subjects with transhumeral amputation or elbow disarticulation and insufficient functional effect of conventional socket-attached arm prostheses.</p><p><strong>Contraindications: </strong>Patients with local or systemic inflammatory processes, bone metabolism disorder, active use of chemotherapeutic or immunosuppressive medications and medically unexplained pain conditions in the respective residual arm.</p><p><strong>Surgical technique: </strong>A cylindrical BADAL next (OTN Implants Germany, Rostock, Germany) humerus implant is transcutaneously inserted using a retrograde press-fit approach. The distal taper of the implant is connected to an adapter that serves as an abutment for the fixation of the postoperative load-set and arm prosthesis.</p><p><strong>Postoperative management: </strong>Postoperative pain medication according to standard guidelines for shoulder surgery. Stoma care instructions before discharge from the hospital. Progressive loading at 6 weeks postoperatively using load plates of 100 g using in a compatible load set. Installation of an external arm prosthesis as soon as the weight of the arm prosthesis is reached.</p><p><strong>Results: </strong>In 4 individuals with median follow-up of 11 months, implant survival was 100%, prosthetic use improved from 0 h to an average 14 h per week, and no arm prosthesis rejection occurred. On a functional level, the 4 individuals improved from 0 to 5 on the patient-reported outcome measure (PROM) 33ADL PWP. This PROM measures 33 daily activities that can or can not be carried out with the prosthesis. No adverse events were reported.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"101-113"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Transcutaneous osseointegrated prosthetic system (TOPS) with an intramedullary prosthesis : Management of the femoral stump with concurrent total hip arthroplasty].","authors":"Thomas von Stein, Julia Rehme-Röhrl","doi":"10.1007/s00064-024-00874-6","DOIUrl":"10.1007/s00064-024-00874-6","url":null,"abstract":"<p><strong>Objective: </strong>Simultaneous implantation of a TOPS (transcutaneous osseointegrated prosthetic system) and THA (total hip arthroplasty) or staged approach.</p><p><strong>Indications: </strong>Patients with a TOPS who have coxarthrosis. Patients with an existing THA who have required above-knee amputation and need a TOPS. Patients with an existing TOPS who sustain a medial femoral neck fracture and are not stabilizable with osteosynthesis.</p><p><strong>Contraindications: </strong>Atypical anatomy, osteomyelitis, radiation or chemotherapy to the affected limb in the last 18 months, peripheral occlusive arterial disease with critical ischemia, diabetes mellitus with polyneuropathy, local dermal or systemic infection, immunocompromised state or use of immunosuppressants, cognitive impairment or lack of compliance for the system, other significant physical impairments.</p><p><strong>Surgical technique: </strong>Individualized preoperative planning based on CT data. Access similar to conventional THA for existing TOPS. Implantation of an artificial acetabulum with a matching inlay. Similar approach for medial femoral neck fractures without reconstructive options. For existing THA and prior above-knee amputation, removal of existing shaft and potentially neck component for modular prosthesis. Subsequent implantation of TOPS stem in conventional manner.</p><p><strong>Postoperative management: </strong>Additional THA requires appropriate rehabilitation following endoprosthesis guidelines, tailored to the TOPS situation. For simultaneous implantation of TOPS and THA the patients' load-bearing capacity and mobilization depend on the duration of the implanted stem.</p><p><strong>Results: </strong>Only 4 patients have been treated at BGU Murnau making statistical analysis not feasible. Three of the 4 patients experienced significant pain relief and improved mobility shortly after surgery. One patient remained as immobile postoperatively as preoperatively due to inability to achieve pain-free full weight-bearing.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"124-132"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}