Orthopadie (Heidelberg, Germany)最新文献

[Patellar cartilage repair-current concepts and evidence]. 髌骨软骨修复的最新概念和证据。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-06-01 Epub Date: 2025-05-05 DOI: 10.1007/s00132-025-04651-6

Roman Karkosch, Alexandra Rahn, Hauke Horstmann

引用次数: 0

[Conservative treatment of patellofemoral cartilage lesions and patellofemoral osteoarthritis]. [髌股软骨病变及髌股骨关节炎的保守治疗]。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-06-01 Epub Date: 2025-04-29 DOI: 10.1007/s00132-025-04650-7

Armin Runer, Paul Nardelli

{"title":"[Conservative treatment of patellofemoral cartilage lesions and patellofemoral osteoarthritis].","authors":"Armin Runer, Paul Nardelli","doi":"10.1007/s00132-025-04650-7","DOIUrl":"10.1007/s00132-025-04650-7","url":null,"abstract":"Background: The causes of patellofemoral cartilage lesions or joint degeneration are multifactorial. Small, traumatic cartilage lesions can be treated without relevant cartilage regenerative therapies. Surgical treatment is recommended for larger lesions (> 1 cm2).Conservative therapy: Conservative therapy is the mainstay of treatment for incipient or advanced patellofemoral osteoarthritis. Consequently, a thorough examination is essential to identify the underlying factors and to establish precise and efficient treatment planning. An individualized, stage-appropriate, and multimodal treatment strategy, supported by comprehensive patient education, is critical for therapeutic success. In the presence of functional or muscular imbalances, physiotherapy and exercise therapy, potentially supplemented by EMG biofeedback training, play a central role. When combined with weight reduction, patellar taping, cryotherapy, or extracorporeal shock wave therapy, these measures form the foundation of any conservative therapeutic approach. In the acute phase, nonsteroidal anti-inflammatory drugs or opioids may be employed for pain relief. If non-injection-based interventions remain ineffective, an injection therapy option may be considered.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"436-443"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014676","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

[Effects of quality assurance in arthroplasty : An evaluation of the development of the semi-annual hospital evaluations of the German Arthroplasty Registry (EPRD)]. [关节成形术质量保证的影响：对德国关节成形术登记处（EPRD）的半年度医院评估发展的评估]。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-06-01 Epub Date: 2025-04-01 DOI: 10.1007/s00132-025-04639-2

Katrin Osmanski-Zenk, Wolfram Mittelmeier, Oliver Melsheimer

{"title":"[Effects of quality assurance in arthroplasty : An evaluation of the development of the semi-annual hospital evaluations of the German Arthroplasty Registry (EPRD)].","authors":"Katrin Osmanski-Zenk, Wolfram Mittelmeier, Oliver Melsheimer","doi":"10.1007/s00132-025-04639-2","DOIUrl":"10.1007/s00132-025-04639-2","url":null,"abstract":"Background: Quality assurance in arthroplasty is based on established systems such as the German Arthroplasty Registry (EPRD) and the EndoCert certification system. These systems enable continuous improvement in the quality of care through targeted feedback and audits. After the introduction of the semi-annual EPRD hospital evaluations, detailed analyses and comparisons of their revision rates for hip and knee arthroplasties (THA, TKA) became possible for the hospitals.Aim of the study: The aim of this study was to compare and evaluate the standardised revision ratios (SRR) of the EPRD clinics.Materials and methods: The study analysed whether poor results in previous evaluations led to an improvement over time. The analysis was based on hospital evaluations from June 2020 and December 2023 for elective THA with cementless stems and standard TKA. Of the 603 clinics with THA responses, 315 were analysed, compared to 360 of the 588 TKA clinics.Results: The results show that regular feedback mechanisms can improve the quality of care; 69.2% of clinics were able to maintain or improve the quality of their THA care and 70.6% of clinics were able to maintain or improve their TKA care. No dependence on case volumes was found, which indicates that all EPRD clinics can benefit equally from the feedback.Discussion: The hospital evaluations enable precise tracking of results, promote transparency and reveal potential for improvement. In view of new legislation such as the Implant Register Act and the hospital reform, it is essential to further strengthen existing systems such as the EPRD and EndoCert and integrate them even more closely into clinical practice in order to ensure the quality of care in the long term.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"478-485"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766172","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

[Patellofemoral joint replacement: onlay or inlay?] 髌股关节置换术：内嵌式还是内嵌式？］

Orthopadie (Heidelberg, Germany) Pub Date : 2025-06-01 Epub Date: 2025-04-28 DOI: 10.1007/s00132-025-04652-5

J Rieger, P Buschner, F Wilken, C Benignus, J Beckmann

引用次数: 0

[Why does the patellofemoral cartilage collapse? : A critical analysis of epidemiology, etiology and prevention]. 髌骨股软骨为什么会塌陷？[流行病学、病因学和预防的批判性分析]。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-06-01 Epub Date: 2025-05-05 DOI: 10.1007/s00132-025-04649-0

A Korthaus, M Krause, K H Frosch, Jannik Frings

{"title":"[Why does the patellofemoral cartilage collapse? : A critical analysis of epidemiology, etiology and prevention].","authors":"A Korthaus, M Krause, K H Frosch, Jannik Frings","doi":"10.1007/s00132-025-04649-0","DOIUrl":"10.1007/s00132-025-04649-0","url":null,"abstract":"Background: Cartilage damage in the patellofemoral joint is common and often leads to pain-related restrictions in the patients' subjective activity level. The cause is often multifactorial.Etiology: The most common causes comprise chronic overuse, acute impact trauma, post-traumatic conditions or patellar fractures, while patellar instability with its anatomical risk factors (trochlear dysplasia, patella alta, lateralized tuberosity, genu valgum or torsional deformities) plays a key role. Acute cartilage damage or (osteo-)chondral fractures usually occur in the context of acute patellar dislocation or direct impact trauma. In this regard, early surgical refixation or resection of the (osteo-)chondral fragments is important and can contribute to a delay of further cartilage deterioration. Chronic cartilage damage usually results from a disorder of the patellofemoral kinematics, such as patellar maltracking. (Post-)traumatic conditions such as patellar fractures represent a special entity. Long-term cartilage deterioration and osteoarthritis can also emerge or progress by inadequate surgical procedures.Therapy: Therapeutically, the main focus should always be on correcting biomechanical imbalances, in order to allow for effective cartilage regeneration. The latter can be achieved by several techniques for cartilage regeneration.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"425-435"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043610","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

[Robotics for patellofemoral joint replacement-a step forward in arthroplasty?] 髌骨股关节置换的机器人技术——关节置换术的一个进步？］

Orthopadie (Heidelberg, Germany) Pub Date : 2025-06-01 Epub Date: 2025-04-28 DOI: 10.1007/s00132-025-04653-4

Mara Hold, Henning Windhagen, Lars-Rene Tuecking

{"title":"[Robotics for patellofemoral joint replacement-a step forward in arthroplasty?]","authors":"Mara Hold, Henning Windhagen, Lars-Rene Tuecking","doi":"10.1007/s00132-025-04653-4","DOIUrl":"10.1007/s00132-025-04653-4","url":null,"abstract":"Background: At 0.2% of all knee replacements implanted in Germany, patellofemoral joint arthroplasty (PFA) account for only a small proportion. However, the potential in the population appears to be significantly greater. In recent years, several robotic-assisted surgical procedures have been developed to increase precision in the implantation of endoprostheses. MAKO® SYSTEM: At present, the Mako® system from Stryker is the only system that can implant an isolated patellofemoral joint replacement robotically. It can be used to analyze and adequately address complex anatomies such as trochlear dysplasia. The system provides support by simulating the positioning of the prosthesis and the exact execution of the plan by aligning the saw or reamer with haptic feedback.Study situation: Studies on robotic-assisted PFA are rare but indicate improved precision with a robotic-assisted procedure. Despite that, an improved clinical and radiological outcome could not be demonstrated in a comparative study.Outlook: A cost-benefit analysis should be discussed here, as should the necessary learning curve. In principle, robotic-assisted implantation of PFA appears to be a promising procedure. However, a superiority of this procedure over conventional methods cannot be postulated at the present time.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"457-465"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060682","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

[Conservative and surgical treatment of femoropatellar osteoarthritis].

Orthopadie (Heidelberg, Germany) Pub Date : 2025-06-01 Epub Date: 2025-06-02 DOI: 10.1007/s00132-025-04643-6

Christoph Becher, Michael T Hirschmann

引用次数: 0

[Five myths around hallux valgus]. 【关于拇外翻的五个误区】。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-06-01 Epub Date: 2025-03-18 DOI: 10.1007/s00132-025-04634-7

Hazibullah Waizy, Leif Claaßen

{"title":"[Five myths around hallux valgus].","authors":"Hazibullah Waizy, Leif Claaßen","doi":"10.1007/s00132-025-04634-7","DOIUrl":"10.1007/s00132-025-04634-7","url":null,"abstract":"Hallux valgus, also known as a bunion, is one of the most frequent deformities of the forefoot. The prevalence is 23% in people between the ages of 18 and 65 years and 36% in people over 65 years of age. Hallux valgus deformity normally begins between the ages of 30 and 60 years. Women are overall more frequently affected than men. Hallux valgus is characterized by the valgus deviation of the big toe and the varus deviation of the first metatarsal bone (MT-I), also known as metatarsus primus varus. This deformity can lead to a pressure point on the medial MT‑I head due to shoe conflict and can restrict mobility. Hallux valgus is typically identifiable by a physical examination. Imaging techniques are important to assess the severity of the deformity and to rule out possible differential diagnoses, such as hallux rigidus. Hallux rigidus is a degenerative change of the first metatarsophalangeal joint (MTP‑I joint) and the second most common cause of pain in the MTP‑I joint. A combination of hallux valgus and hallux rigidus is not uncommon. The treatment of hallux valgus initially focuses on nonsurgical approaches such as wider shoes, orthoses and nocturnal splints. If conservative treatment is not effective, surgical treatment provides a proven therapeutic benefit. In recent years minimally invasive techniques have also made progress in foot surgery. In addition to the reduced soft tissue trauma, the extra-articular approach in particular shows a significant advantage. This article provides a current overview of hallux valgus by addressing five widespread myths.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"491-502"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660015","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

[Guideline for the treatment of patellofemoral cartilage defects/arthrosis]. [髌骨股软骨缺损/关节病治疗指南]。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-06-01 Epub Date: 2025-03-20 DOI: 10.1007/s00132-025-04644-5

Christoph Becher, Michael T Hirschmann

引用次数: 0

[Knee arthroplasty in isolated patellofemoral osteoarthritis : A critical review of the best options]. [孤立性髌股骨关节炎的膝关节置换术：最佳选择的关键回顾]。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-06-01 Epub Date: 2025-05-02 DOI: 10.1007/s00132-025-04654-3

Alec Voordeckers, George Avram, Natalie Mengis, Laszlo Toth, Matthias Koch, Michael T Hirschmann, Elias Ammann

{"title":"[Knee arthroplasty in isolated patellofemoral osteoarthritis : A critical review of the best options].","authors":"Alec Voordeckers, George Avram, Natalie Mengis, Laszlo Toth, Matthias Koch, Michael T Hirschmann, Elias Ammann","doi":"10.1007/s00132-025-04654-3","DOIUrl":"10.1007/s00132-025-04654-3","url":null,"abstract":"Background: Isolated patellofemoral osteoarthritis is a degenerative disease of the knee joint that may cause disabling pain and functional limitations. When conservative therapy has failed, arthroplasty can significantly improve the quality of life and mobility of affected patients. In such cases, it is important to select the most suitable implant for the patient on an individual basis. This article discusses the decision-making process between patellofemoral arthroplasty, total knee replacement, and bicondylar replacement without patellar resurfacing.Therapeutic options: Patellofemoral arthroplasty is mainly used in younger patients and, if implanted correctly, can lead to good results and a delay in the need for total knee replacement. In older patients with isolated patellofemoral osteoarthritis, total knee replacement is usually the preferred option due to its predictable good outcomes and a lower revision rate. In selected cases, particularly with severely thinned patella, retropatellar resurfacing should not be done.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"466-472"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058816","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