Orthopadie (Heidelberg, Germany)最新文献

{"title":"Clarifying allocation, measurement reliability and phenotype reporting in robotic-assisted TKA.","authors":"Filippo Migliorini, Nicola Maffulli, Luise Schäfer, Jens Schneider, Andrea Maria Nobili, Daniel Kämmer, Andreas Bell","doi":"10.1007/s00132-026-04899-6","DOIUrl":"https://doi.org/10.1007/s00132-026-04899-6","url":null,"abstract":"","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond alignment accuracy: the need for standardized reporting in functional alignment TKA.","authors":"Soner Kocak","doi":"10.1007/s00132-026-04897-8","DOIUrl":"https://doi.org/10.1007/s00132-026-04897-8","url":null,"abstract":"","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[30/m- Flatfoot treated with insoles : Preparation for the specialist examination-Case 85].","authors":"Stefan Schwinghammer, Stephan Riedl, Norbert Harrasser","doi":"10.1007/s00132-026-04900-2","DOIUrl":"https://doi.org/10.1007/s00132-026-04900-2","url":null,"abstract":"","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Acute diagnostics-focus on septic arthritis].","authors":"Lukas Bönnen, Christian Heiß, Markus Rupp, Christoph Biehl","doi":"10.1007/s00132-026-04898-7","DOIUrl":"https://doi.org/10.1007/s00132-026-04898-7","url":null,"abstract":"<p><p>Septic arthritis represents a medical emergency in daily clinical practice due to its high mortality. It requires time-critical diagnostic evaluation and treatment. Patients with inflammatory arthritis (IA) are at particularly high risk. The current article is based on a literature search on septic arthritis, with a focus on the diagnostic value of systemic and synovial laboratory parameters in patients with IA. The results show that in patients with IA, any isolated arthritis should initially be considered septic until proven otherwise. Simple laboratory cut-off values are insufficient for reliable diagnosis. Early joint aspiration with microbiological diagnostics and prompt escalation of therapy in cases of suspected septic arthritis are critical determinants of treatment success.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and radiographic outcomes of the calcaneo-stop procedure for symptomatic flexible flatfoot in adolescents : A retrospective cohort study of 160 feet.","authors":"Moaaz Ali Hamoud, Ahmed Swealem, Mohamed Hatata","doi":"10.1007/s00132-026-04868-z","DOIUrl":"https://doi.org/10.1007/s00132-026-04868-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Symptomatic flexible flatfoot is a common musculoskeletal disorder among children and adolescents, characterized by hindfoot valgus, medial arch collapse and forefoot abduction under weight-bearing conditions. When conservative treatment fails, the calcaneo-stop procedure offers a minimally invasive, joint-preserving surgical option.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the clinical and radiological outcomes of the calcaneo-stop procedure in adolescents with symptomatic flexible flatfoot refractory to conservative care, with emphasis on postoperative complications and their management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients and methods: &lt;/strong&gt;A retrospective cohort analysis was conducted on 160 feet in 90 patients (45 males, 45 females) aged 12-17 years. Clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and hindfoot valgus angle. Radiological parameters included calcaneal pitch angle, Kite's angle, talar declination angle, Meary's angle and talonavicular coverage angle, evaluated preoperatively, immediately postoperatively and at final follow-up (mean 24.3 ± 1.8 months). A linear mixed-effects model was employed to account for bilateral clustering (70 patients with bilateral procedures).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All radiological parameters and functional outcome scores demonstrated statistically significant improvement (all p &lt; 0.001) with large effect sizes (η&lt;sup&gt;2&lt;/sup&gt; = 0.415-0.678). Hindfoot valgus angle decreased from 10.12° ± 1.83° preoperatively to 3.03° ± 1.15° at final follow-up (total reduction 7.07°). Calcaneal pitch increased by 5.51° (12.58° ± 2.11° to 18.09° ± 1.71°). Kite's angle declined by 7.34° (32.44° ± 3.20° to 25.10° ± 2.53°), talar declination by 10.02° (40.88° ± 4.17° to 30.93° ± 3.28°), Meary's angle by 6.97° (21.04° ± 3.45° to 14.18° ± 2.54°) and talonavicular coverage angle by 8.33° (28.71 ± 3.38° to 20.39 ± 2.61°). The AOFAS score improved from 72.17 ± 7.34 to 92.08 ± 5.91 (total gain + 19.92 points). Mixed-effects modelling confirmed these findings after accounting for within-patient clustering (intraclass correlation coefficient, ICC = 0.21-0.27). Postoperative complications occurred in 15 feet (9.375%), including surgical site pain (3.75%), local wound swelling (2.50%), superficial infection (1.25%), asymptomatic screw loosening (1.25%) and overcorrection requiring screw revision (0.625%). All complications resolved without implant removal.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The calcaneo-stop procedure was associated with statistically significant and clinically meaningful improvements in functional scores and multiplanar radiological parameters at a mean follow-up of 24.3 months in skeletally immature patients. The observed complication rate of 9.375% appears comparable with previously published series. Longer follow-up beyond skeletal maturity and implant removal is required to establish the durability of correctio","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Computer-assisted sensing in periprosthetic joint infection : Current evidence and future perspectives for wearables].","authors":"Maximilian Weyer, Christina Valle, Ricardo Smits, Florian Hinterwimmer, Rüdiger von Eisenhart-Rothe, Igor Lazic","doi":"10.1007/s00132-026-04874-1","DOIUrl":"10.1007/s00132-026-04874-1","url":null,"abstract":"<p><strong>Background: </strong>Periprosthetic joint infection (PJI) is among the most serious complications after hip and knee arthroplasty and requires timely diagnosis and a close follow-up. In parallel with the digital transformation of medicine, wearables (e.g., inertial sensors) and computer-assisted sensing are increasingly being used to generate objective data on function, mobility, and physiological parameters throughout the entire treatment pathway.</p><p><strong>State of the research: </strong>In arthroplasty, current evidence for wearables is strongest in rehabilitation and outcome monitoring, although important limitations remain, including device heterogeneity, patient adherence, and the lack of standardized assessment protocols. At present, only a few studies have addressed their role in the prediction, diagnosis, prevention, and rehabilitation of PJI. Potential applications therefore appear to lie less in direct infection detection than in the identification of nonspecific warning signals, such as persistently reduced activity or disturbed circadian patterns, which may trigger structured diagnostic work-up and longitudinal follow-up within established PJI frameworks. Comparable concepts have already been explored in the diagnosis and management of sepsis.</p><p><strong>Discussion: </strong>For PJI-specific monitoring, implantable sensing concepts (\"smart implants\") appear particularly promising from a translational perspective, as local parameters such as pH, temperature, and metabolites can already be assessed in experimental as well as early preclinical and clinical settings. This article summarizes the current evidence on wearables in arthroplasty with a focus on PJI and discusses key requirements for clinical utility, validation, data security, and implementation.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"784-789"},"PeriodicalIF":0.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Robotic knee arthroplasty-an evidence-based, narrative assessment of the current state].","authors":"Fabian Westhauser, Stefano Pagano, Marie T Heller, Max Thieme, Tobias Renkawitz","doi":"10.1007/s00132-026-04888-9","DOIUrl":"10.1007/s00132-026-04888-9","url":null,"abstract":"<p><strong>Background: </strong>Robotically assisted knee arthroplasty (r-CAS) enables highly precise implant placement. However, current evidence shows no consistent advantage in clinical outcomes or implant survivorship. Scientific evaluation is challenged by both the technical heterogeneity of robotic systems and the rapid evolution of software, including AI-driven optimization algorithms. These differences affect workflow, accuracy, and outcomes, limiting study comparability.</p><p><strong>Prospects: </strong>Future value will likely lie less in further improving precision and more in enabling personalized treatment through integration of kinematic analysis and intelligent decision-support models. This will require not only advanced hardware, software, and algorithms, but also new dynamic real-world evidence approaches to assess patient benefit.The present article provides an overview of the current state of evidence-based research for r-CAS and discusses approaches for bringing rapid technological advancements into balance with valid, patient-centered research in the future.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"790-795"},"PeriodicalIF":0.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Functional vs. mechanical TKA alignment : An EbM analysis of the study by Young et al.]","authors":"Jakob Bollmann, Moritz Innmann","doi":"10.1007/s00132-026-04885-y","DOIUrl":"10.1007/s00132-026-04885-y","url":null,"abstract":"","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"833-835"},"PeriodicalIF":0.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Does endoprosthetic treatment of medial femoral neck fractures in obese patients using a minimally invasive anterolateral approach have a higher complication rate? : A retrospective case-control study].","authors":"Ferdinand Zellner, Christian Wulbrand, Bernd Füchtmeier, Michael Zellner, Franz Müller","doi":"10.1007/s00132-026-04841-w","DOIUrl":"10.1007/s00132-026-04841-w","url":null,"abstract":"<p><strong>Background: </strong>Different minimally invasive approaches have been established in the management of elective hip arthroplasty. However, there is almost no data on the endoprosthetic treatment of femoral neck fractures in obese patients.</p><p><strong>Materials and methods: </strong>The monocentric case-control study is based on the retrospective evaluation of a database. Included were patients with a body mass index (BMI) of > 30 kg/m² who received endoprosthetic treatment due to a femoral neck fracture. The cohort was dichotomized based on the surgical approach: direct lateral (DL) and minimally invasive anterolateral (MIV AL). Demographic and perioperative variables were collected. The primary study objective was the comparison of general and specific complications. The secondary study objective was the comparison of survival rate and mobility according to the Parker score.</p><p><strong>Results: </strong>A total of 155 surgeries conducted between 2011 and 2024 were included, of which 52 procedures were performed using a DL approach and 103 procedures using an MIV AL approach. The mean age of the overall cohort was 77.9 ± 9.4 years, and the mean BMI was 33.4 ± 3.2 kg/m². The demographic variables showed a homogeneous distribution. The overall revision rate was noticeably higher for the MIV AL approach, but not statistically significant (p = 0.18). Dislocations (n = 7) and infections (n = 3) occurred exclusively in the MIV AL group. There was no significant difference in mortality or survival rates. The 30-day and 1‑year mortality rates were 0% and 9.0%, respectively (p = 0.776). The mean survival rate according to Kaplan-Meier was 7.1 years (95% confidence interval, 6.12-8.03) without significant differences regarding the surgical approaches (log rank = 0.656). Mobility according to Parker (n = 78) at the time of follow-up was also comparable (p = 0.60).</p><p><strong>Conclusion: </strong>The MIV AL approach to endoprosthetic treatment of femoral neck fractures in obese patients showed a higher, but not significant, dislocation and infection rate compared to the DL approach. For the overall cohort, mortality rates were low. Recording the surgical approaches and BMI in registry data would be useful to generate larger case numbers.</p><p><strong>Level of evidence: </strong> III; retrospective case-control study.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"802-811"},"PeriodicalIF":0.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Virtual reality and digital shoulder surgery].","authors":"Anna-Katharina Nolte, Jonas-Georg Schmalzl, Svenja Haag, Isabel Bettina Seifert, Lars-Johannes Lehmann","doi":"10.1007/s00132-026-04869-y","DOIUrl":"10.1007/s00132-026-04869-y","url":null,"abstract":"<p><p>Digital technologies are increasingly expanding the scope of shoulder surgery. In shoulder arthroplasty, CT-based three-dimensional (3D-) planning has become established for assessing glenoid morphology, selecting implants, and virtually positioning components. Patient-specific instrumentation (PSI) and computer-assisted navigation aim to translate preoperative planning into the operating room with greater precision. Virtual reality (VR) currently plays its most relevant role in shoulder surgical education and simulation. Augmented reality (AR) and mixed reality (MR) may enable intraoperative visualization of planning data and telemedical supervision, however, their intraoperative application should still be considered experimental. Despite promising technological advances, evidence demonstrating long-term clinical benefit, reduced revision rates, or cost-effectiveness remains limited.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"767-776"},"PeriodicalIF":0.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}