Orthopadie (Heidelberg, Germany)最新文献

Risk factors for transtibial amputation after minor amputation in diabetic foot patients. 糖尿病足患者轻微截肢后经胫部截肢的危险因素。

IF 0.5

Orthopadie (Heidelberg, Germany) Pub Date : 2025-10-07 DOI: 10.1007/s00132-025-04728-2

Erdi Imre, Mustafa Görkem Kaya, Muhammed Can Arı, Alev Kural, Cemal Kural

{"title":"Risk factors for transtibial amputation after minor amputation in diabetic foot patients.","authors":"Erdi Imre, Mustafa Görkem Kaya, Muhammed Can Arı, Alev Kural, Cemal Kural","doi":"10.1007/s00132-025-04728-2","DOIUrl":"https://doi.org/10.1007/s00132-025-04728-2","url":null,"abstract":"Background: Diabetic foot ulcers are a serious complication of diabetes, often leading to deep tissue infections, osteomyelitis and gangrene, with subsequent risk of amputations. Diabetic foot disease (DFD) affects 15-25% of diabetic patients and 15% of these cases require amputation. This study aims to investigate factors associated with transtibial amputation following minor amputation.Methods: A retrospective analysis was conducted on diabetic patients who underwent minor amputation for DFD at a tertiary center between 2012 and 2022. Minor amputations were defined as those occurring between toes and ankle joint, while transtibial amputations were those occurring between the ankle and knee joint within 6 months of a minor amputation. Clinical and demographic data were collected and analyzed.Results: A total of 93 patients were included in the study, with 66 in the minor amputation group and 27 in major amputation group. There were no significant differences in age (p = 0.793) or gender (p = 0.500). Inflammatory markers and blood tests showed no significant differences between the groups. The presence of osteomyelitis (p = 0.047) and the number of surgical debridements required (p < 0.001) were significantly higher in the major amputation group. The ROC curve analysis indicated that number of surgical debridements was a strong predictor for transtibial revision (AUC = 0.838).Conclusion: The presence of osteomyelitis and need for multiple surgical debridements are associated with higher risk of transtibial amputation following minor amputation in diabetic patients. Prospective, randomized controlled studies with larger patient samples are needed to confirm these findings.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240569","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}

引用次数: 0

[Trabecular bone density measurement in Hounsfield units in the proximal femur for osteoporosis assessment and fracture risk determination]. [股骨近端Hounsfield单元骨小梁密度测量用于骨质疏松评估和骨折风险确定]。

IF 0.5

Orthopadie (Heidelberg, Germany) Pub Date : 2025-10-02 DOI: 10.1007/s00132-025-04726-4

Julian Ramin Andresen, Thomas Haider, Reimer Andresen

{"title":"[Trabecular bone density measurement in Hounsfield units in the proximal femur for osteoporosis assessment and fracture risk determination].","authors":"Julian Ramin Andresen, Thomas Haider, Reimer Andresen","doi":"10.1007/s00132-025-04726-4","DOIUrl":"https://doi.org/10.1007/s00132-025-04726-4","url":null,"abstract":"Background: Osteoporosis leads to fractures, especially in older patients after minor trauma. Hip fractures are frequent.Research question: The study investigated whether bone mineral density (BMD) and T‑scores can be calculated based on trabecular density in Hounsfield units (HU) in the proximal femur, and whether the presence of osteoporosis and fracture risk can be assessed.Patients and methods: 370 patients (Ø 69.4 years, 53 men/317 women) were examined using CTXA hip (DEXA equivalent). In addition, HU measurements were taken in the CT cross-section of the caput femoris and proximal femur. Fractures were recorded using supplementary imaging.Results: Trabecular bone density decreased significantly with increasing age and decreasing BMI. There was a strong correlation between HU values and BMD (R2 = 0.88) as well as T‑score (R2 = 0.89). A threshold value of 96 HU showed high predictive power for osteoporosis (AUC = 0.97) for the proximal femur region, for the femoral head, the threshold value was 245.5 HU. The fracture threshold value was 245.5 HU for the femoral head and 75 HU for the proximal femur.Discussion: HU measurement in native CT cross-sectional images allows a reliable assessment of osteoporosis and fracture risk. Opportunistic HU evaluation alone is, therefore, practicable and sufficient.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208412","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}

引用次数: 0

[Challenges in Arthroplasty : Contributions from the AE Sessions of the DKOU 2024]. [关节成形术中的挑战：来自DKOU 2024 AE会议的贡献]。

IF 0.5

Orthopadie (Heidelberg, Germany) Pub Date : 2025-10-01 Epub Date: 2025-09-23 DOI: 10.1007/s00132-025-04710-y

Stephan Kirschner

引用次数: 0

[Debridement, antimicrobial therapy, and implant retention for acute periprosthetic infections]. 急性假体周围感染的清创、抗菌治疗和种植体保留。

IF 0.5

Orthopadie (Heidelberg, Germany) Pub Date : 2025-10-01 Epub Date: 2025-09-06 DOI: 10.1007/s00132-025-04716-6

Dirk Müller, Stephan Kirschner, Benjamin Schloßmacher, Rüdiger von Eisenhart-Rothe, Igor Lazic

{"title":"[Debridement, antimicrobial therapy, and implant retention for acute periprosthetic infections].","authors":"Dirk Müller, Stephan Kirschner, Benjamin Schloßmacher, Rüdiger von Eisenhart-Rothe, Igor Lazic","doi":"10.1007/s00132-025-04716-6","DOIUrl":"10.1007/s00132-025-04716-6","url":null,"abstract":"Background: The DAIR procedure (debridement, antibiotic therapy, and implant retention) represents a treatment option for acute periprosthetic joint infections (PJI). Compared to revision arthroplasty, it is technically less invasive and, under appropriate indications, can preserve a well-fixed endoprosthesis. However, treatment success depends on numerous patient-, pathogen-, and procedure-related factors.Methods: Based on a comprehensive review of current international studies and guidelines, we systematically analyzed the key factors influencing the success of DAIR. In addition, clinical experiences from our orthopedic department, particularly with staphylococcal infections, were evaluated and integrated.Results: Critical success factors for DAIR include early intervention within 3 weeks of symptom onset, exchange of all mobile components, stable implant fixation, intact soft tissue envelope, and consideration of risk factors such as advanced age, immunosuppressive therapy, COPD, or rheumatoid arthritis. The choice of antibiotic regimen, especially rifampicin-based combination therapy for staphylococcal infections, affects the outcome significantly.Conclusion: DAIR can be an effective treatment option with favorable healing rates under clearly defined conditions. Careful patient selection, a multidisciplinary case review, and strict adherence to surgical and antimicrobial standards are essential to improve success rates. In unfavorable clinical situations, a direct implant revision should be considered instead.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"777-784"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[20% dissatisfied patients-Is this still true?] 20%的病人不满意——现在还是这样吗？］

IF 0.5

Orthopadie (Heidelberg, Germany) Pub Date : 2025-10-01 Epub Date: 2025-08-19 DOI: 10.1007/s00132-025-04705-9

Julia Kirschberg, Georg Matziolis

引用次数: 0

[Hydraulically controlled isokinetic strength testing]. [液压控制等速强度试验]。

IF 0.5

Orthopadie (Heidelberg, Germany) Pub Date : 2025-10-01 Epub Date: 2025-07-17 DOI: 10.1007/s00132-025-04670-3

Jan Schröder, Miriam Knauer, Gunnar Liedtke

{"title":"[Hydraulically controlled isokinetic strength testing].","authors":"Jan Schröder, Miriam Knauer, Gunnar Liedtke","doi":"10.1007/s00132-025-04670-3","DOIUrl":"10.1007/s00132-025-04670-3","url":null,"abstract":"Background: Hydraulically controlled strength test devices provide a constant predetermined movement velocity, and as such may be specified as (quasi‑)isokinetic dynamometry. There are limited literature reporting comparisons with other strength testing modes. This work presents reference values and reliability analyses for trunk and knee maximum torques and their respective flexion-extension ratios for hydraulically controlled isokinetic dynamometry in comparison to isometric strength testing.Materials and methods: In a cross-sectional design, reference values (M, SD, percentiles) of 45 healthy adults (21 females, age 26.1 ± 3.9 years, BMI 23.2 ± 2.5 kg/m2) were assessed (trunk, knee: flexion, extension and their functional ratios) for the Factum® test devices (Frei medical) including, comparisons of the isometric or isokinetic test mode (Bland-Altman). For a sub-sample of 20 persons (50% females), time economy and reliability (ICC3.k) were assessed.Results: The (quasi‑)isokinetic test protocol was less time consuming (50%) and demonstrated higher reliability coefficients (ICC3.k 0.736-0.933) compared to isometric testing (ICC3.k 0.550-0.899). Flexion-extension ratios (isokinetic 68%, isometric trunk 63%) revealed a relation nearby 2:3, except for the isometric knee ratio (55% ≈ 1:2), due to smaller proportions of knee flexion forces.Conclusion: Results indicated mode specific differences and are not directly comparable with clinical implications especially for the flexion-extension ratios. Each protocol showed to be sufficiently reliable with time economy advantages for the (quasi‑)isokinetic protocol. Distributions of body weight-adjusted peak torques and functional ratios may serve as device-specific benchmark values for strength testing in clinical environments.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"785-794"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Approach-specific complication management in direct anterior approach total hip arthroplasty. 直接前路全髋关节置换术并发症的处理。

IF 0.5

Orthopadie (Heidelberg, Germany) Pub Date : 2025-10-01 Epub Date: 2025-08-28 DOI: 10.1007/s00132-025-04707-7

Salome Hagelstein, Lennart Marvin Schröder, Florian Pachmann, Dominic Simon, Boris Michael Holzapfel, Gautier Beckers

引用次数: 0

[Arthrofibrosis after total knee arthroplasty-Diagnosis and management]. 全膝关节置换术后关节纤维化的诊断和处理。

IF 0.5

Orthopadie (Heidelberg, Germany) Pub Date : 2025-10-01 Epub Date: 2025-08-21 DOI: 10.1007/s00132-025-04706-8

Anne Postler, Franziska Beyer, Daniel Magnus, Eric Tille, Jörg Lützner

引用次数: 0

[Tibial derotation osteotomy for knee joint pathologies : Indications, surgical technique and overview of the current literature]. [胫骨旋转截骨术治疗膝关节病变：指征、手术技术和当前文献综述]。

IF 0.5

Orthopadie (Heidelberg, Germany) Pub Date : 2025-10-01 Epub Date: 2025-07-14 DOI: 10.1007/s00132-025-04675-y

Michael Liebensteiner, Clelia Appel-Ersek, Gerhard Kaufmann, Markus Neubauer, Johannes Neugebauer, Dietmar Dammerer

引用次数: 0

[Revision analysis and successful solutions for my failed primary total knee arthroplasties]. 【原发性全膝关节置换术失败的修正分析及成功对策】。

IF 0.5

Orthopadie (Heidelberg, Germany) Pub Date : 2025-10-01 Epub Date: 2025-09-03 DOI: 10.1007/s00132-025-04714-8

Friedrich Boettner, Mohammed El-Hassan, Johannes M Herold

{"title":"[Revision analysis and successful solutions for my failed primary total knee arthroplasties].","authors":"Friedrich Boettner, Mohammed El-Hassan, Johannes M Herold","doi":"10.1007/s00132-025-04714-8","DOIUrl":"10.1007/s00132-025-04714-8","url":null,"abstract":"Background: The treatment of patients following primary total knee arthroplasty requiring revision surgery is one of the most demanding tasks in orthopedic surgery. A careful failure analysis and a systematic approach are of great importance for the often very individual situations. In addition to excellent technical skills, preoperative planning is of great importance.Question: This paper describes the preoperative assessment and planning, as well as the technical strategy for the revision of primary knee arthroplasties.Material and methods: Beside a review of the existing literature, the article introduces the senior author's revision strategies based on 20 years of experience in total joint replacement.Results: Adequate preoperative imaging, laboratory tests and, if necessary, joint aspiration are essential for the individual diagnostics and planning of the revision procedure. The article focuses on the prophylaxis and treatment options for acute and chronic periprosthetic joint infections, aseptic implant loosening, arthrofibrosis and joint instability.Discussion: It is often a challenge for the surgeon to face his/her own patient requiring a revision surgery, and the patient expects the same result for these technical, often much more demanding operations as for the primary surgery. This inherent conflict results in considerable challenges for the arthroplasty surgeon.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"760-768"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981607","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}

引用次数: 0