Orthopadie (Heidelberg, Germany)最新文献

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[Short-stem THA-complications and therapy options]. [短茎tha并发症和治疗方案]。
Orthopadie (Heidelberg, Germany) Pub Date : 2025-06-05 DOI: 10.1007/s00132-025-04663-2
Karl Philipp Kutzner
{"title":"[Short-stem THA-complications and therapy options].","authors":"Karl Philipp Kutzner","doi":"10.1007/s00132-025-04663-2","DOIUrl":"https://doi.org/10.1007/s00132-025-04663-2","url":null,"abstract":"<p><p>Short stems in total hip arthroplasty are increasingly being established and offer several advantages in terms of minimal invasiveness and bone preservation compared to standard implants. The rounded design and shorter stem length facilitate better adaptation to natural anatomy, at the same time also posing specific risks and complications. When transitioning to short stems, a learning curve must be considered. Careful patient selection and preoperative planning are crucial, and intraoperative imaging is recommended. The most common implant-specific complications include insufficient osseointegration, leading to subsidence and aseptic loosening, as well as periprosthetic fractures. The risk instability and dislocations as well as periprosthetic infections can potentially be reduced with short stems. This article discusses the frequency, causes, and treatment options for these types of complications and highlights current evidence-based treatment approaches.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236155","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
[Medical malpractice in primary total hip arthroplasty : Why is there a medical malpractice clause?] 初级全髋关节置换术中的医疗事故:为什么会有医疗事故条款?]
Orthopadie (Heidelberg, Germany) Pub Date : 2025-06-05 DOI: 10.1007/s00132-025-04664-1
Moritz Innmann, Marcus Schiltenwolf
{"title":"[Medical malpractice in primary total hip arthroplasty : Why is there a medical malpractice clause?]","authors":"Moritz Innmann, Marcus Schiltenwolf","doi":"10.1007/s00132-025-04664-1","DOIUrl":"https://doi.org/10.1007/s00132-025-04664-1","url":null,"abstract":"<p><p>The provision of a hip endoprosthesis for coxarthrosis is one of the most common medical procedures associated with treatment errors. These errors are most frequently identified in the surgical execution. The most crucial prerequisite for preventing treatment errors is correct and guideline-compliant indication. Additionally, proper execution and documentation of both risk disclosure and precautionary disclosure are essential. Patient-specific factors, such as comorbidities or anatomical peculiarities, must be taken into account, as they are identified during mandatory preoperative planning. For postoperative radiological measurement parameters (e.g., implant positioning and leg length), clear and universally valid target values with acceptable deviations have not been definitively established. However, recommended values help assess whether an implantation error is present. Furthermore, a causal relationship between damage (e.g., dislocation, muscle weakness) and implantation errors must be established.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236154","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
[Endoprosthetics as an essential component of surgical training in Bundeswehr surgery]. [Endoprosthetics是联邦国防军外科手术训练的重要组成部分]。
Orthopadie (Heidelberg, Germany) Pub Date : 2025-06-05 DOI: 10.1007/s00132-025-04661-4
Peter Springer, Falk von Lübken
{"title":"[Endoprosthetics as an essential component of surgical training in Bundeswehr surgery].","authors":"Peter Springer, Falk von Lübken","doi":"10.1007/s00132-025-04661-4","DOIUrl":"https://doi.org/10.1007/s00132-025-04661-4","url":null,"abstract":"<p><strong>Background: </strong>Against the backdrop of the Russian war of aggression in Ukraine, the public focus is increasingly on military defense and to be ready for action in the context of armed conflict situations. The medical service of the German Bundeswehr and the surgical care of soldiers play an important role here.</p><p><strong>Military surgical training: </strong>However, the training to become a military surgeon is extremely complex, as broad knowledge and skills in various areas of surgery must be acquired and maintained. Obviously, the main focus seems to be on further training in the treatment of thermodynamic combination injuries, such as those that occur in explosions or mine injuries, as well as gunshot wounds. The number of such injuries and thus necessary operations is, of course, too low in everyday life in Germany to be able to guarantee sound surgical training and maintenance, so that further training must be based on alternative foundations. As part of military surgical training, complex procedures of higher severity such as endoprosthetic replacement can therefore act as an important component.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227797","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
[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
{"title":"[Patellar cartilage repair-current concepts and evidence].","authors":"Roman Karkosch, Alexandra Rahn, Hauke Horstmann","doi":"10.1007/s00132-025-04651-6","DOIUrl":"10.1007/s00132-025-04651-6","url":null,"abstract":"<p><p>Due to their unique anatomy and biomechanics, patellar cartilage defects are both common and challenging to manage. In cases of persistent instability or dysplasia, bony and ligamentous procedures are necessary to correct patellar tracking and reduce patellofemoral forces. Only after addressing these underlying issues can cartilage restoration be performed effectively. Currently, a wide array of cartilage repair techniques is available, demonstrating favorable clinical outcomes; however, no single method has emerged as superior. If left untreated, cartilage defects of the patella often progress to functional impairment and pain, culminating in end-stage patellofemoral osteoarthritis.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"444-449"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994010","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 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":"<p><strong>Background: </strong>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 cm<sup>2</sup>).</p><p><strong>Conservative therapy: </strong>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.</p>","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":"<p><strong>Background: </strong>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.</p><p><strong>Aim of the study: </strong>The aim of this study was to compare and evaluate the standardised revision ratios (SRR) of the EPRD clinics.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Discussion: </strong>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.</p>","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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766172","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
[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
{"title":"[Patellofemoral joint replacement: onlay or inlay?]","authors":"J Rieger, P Buschner, F Wilken, C Benignus, J Beckmann","doi":"10.1007/s00132-025-04652-5","DOIUrl":"10.1007/s00132-025-04652-5","url":null,"abstract":"<p><p>Patellofemoral prosthesis procedures are still rarely performed in Germany. However, with strict indications and thorough preoperative preparation, it can be a viable alternative to total knee arthroplasty (TKA). If conservative treatment methods prove ineffective, the question arises not only as to whether the advantages of an isolated joint replacement outweigh those of a total prosthesis, but also regarding patellofemoral joint replacement: should an inlay or an onlay prosthesis be used?</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"450-456"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044462","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
[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":"<p><strong>Background: </strong>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.</p><p><strong>Etiology: </strong>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.</p><p><strong>Therapy: </strong>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.</p>","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":"<p><strong>Background: </strong>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.</p><p><strong>Study situation: </strong>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.</p><p><strong>Outlook: </strong>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.</p>","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]. 股髌骨关节炎的保守和手术治疗。
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
{"title":"[Conservative and surgical treatment of femoropatellar osteoarthritis].","authors":"Christoph Becher, Michael T Hirschmann","doi":"10.1007/s00132-025-04643-6","DOIUrl":"https://doi.org/10.1007/s00132-025-04643-6","url":null,"abstract":"","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":"54 6","pages":"411-412"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200960","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
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