Orthopadie (Heidelberg, Germany)最新文献

[Literature review on kyphoplasty as a treatment for osteoporotic fractures of the spine].

Orthopadie (Heidelberg, Germany) Pub Date : 2025-04-04 DOI: 10.1007/s00132-025-04648-1

Celine Zöllinger, Franz Landauer, Klemens Trieb

{"title":"[Literature review on kyphoplasty as a treatment for osteoporotic fractures of the spine].","authors":"Celine Zöllinger, Franz Landauer, Klemens Trieb","doi":"10.1007/s00132-025-04648-1","DOIUrl":"https://doi.org/10.1007/s00132-025-04648-1","url":null,"abstract":"Background: Osteoeporotic vertebral fractures are one of the most common injuries in the elderly, with a prevalence of 10 to 15% in the population over 50 years of age. This type of fracture can be treated with minimally invasive surgery using kyphoplasty. The aim of this analysis is to show the advantages and disadvantages of treatment with kyphoplasty and to weigh up the different ways of performing this operation.Methods: The systematic literature search included randomized controlled trials and clinical studies in the period from 01/09/2018-31/08/2024. The updated 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used for evaluation.Results: A total of 16 studies from 4347 datasets were included. The most relevant outcome indices showed that the sole choice of surgical side (surgery from the symptom-dominant side) positively influences the VAS. In addition, the unilateral approach is recommended, as this is associated with a shorter operation time, as well as reduced cement volume and radiation exposure. Furthermore, bone density, different scores and certain biomarkers, such as NMID, beta-CTX and P1NP, can be positively influenced by the intravenous administration of zoledronic acid. PMMA bone cement loaded with gentamicin should be used as cement. Finally, drug treatment for osteoporosis and physical therapy are essential for postoperative recovery.Conclusion: Surgical treatment of an osteoporotic vertebral fracture by means of kyphoplasty leads to improved results, even with the inclusion of additional therapies.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788868","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

[The weight-loss injection : An orthopaedic overview].

Orthopadie (Heidelberg, Germany) Pub Date : 2025-04-01 Epub Date: 2025-02-03 DOI: 10.1007/s00132-025-04609-8

Saif Al Basri, Wiebke K Fenske

{"title":"[The weight-loss injection : An orthopaedic overview].","authors":"Saif Al Basri, Wiebke K Fenske","doi":"10.1007/s00132-025-04609-8","DOIUrl":"10.1007/s00132-025-04609-8","url":null,"abstract":"Background: The increasing prevalence of obesity represents a significant and growing challenge in orthopaedic surgery. This is particularly true for patients with morbid obesity, who have a significantly increased risk of postoperative complications. The newer incretin-based therapies (such as semaglutide and tirzepatide), these so-called \"weight loss injections\", offer promising potential for preoperative weight reduction and minimisation of peri- and postoperative complications.Study situation: However, the evidence regarding their influence on postoperative outcomes is inconsistent. Retrospective studies suggest that rapid weight loss immediately prior to orthopaedic surgery may increase the risk of complications, including septic shock and revision surgery. Meta-analyses, on the other hand, indicate potential protective effects in surgical outcomes with prior long-term weight reduction.Conclusion: There are currently no sufficiently qualitative studies on the safety and efficacy of these new drugs in the orthopaedic surgery sector. An individualised and multidisciplinary approach, therefore, remains relevant in order to achieve an optimal surgical outcome for the individual patient.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"278-282"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124163","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

[Diabetes mellitus and obesity: risk optimization before surgical interventions]. 糖尿病与肥胖：手术干预前的风险优化。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-04-01 Epub Date: 2025-01-21 DOI: 10.1007/s00132-024-04604-5

Stephan Martin

{"title":"[Diabetes mellitus and obesity: risk optimization before surgical interventions].","authors":"Stephan Martin","doi":"10.1007/s00132-024-04604-5","DOIUrl":"10.1007/s00132-024-04604-5","url":null,"abstract":"Background: The prevalence of obesity has increased significantly in recent years and is a causal risk factor for the development of type 2 diabetes. Moreover, chronic degenerative joint diseases are also triggered by obesity.Weight loss: Both obesity-related secondary diseases-type 2 diabetes and chronic degenerative joint disease-can be prevented or at least delayed by lifestyle intervention aimed at weight reduction. The progression of these diseases can also be favourably influenced by radical weight loss. Diets with a reduction in carbohydrates-a so-called \"low-carb\" or ketogenic diet-appear to be superior to a low-fat diet.Surgical treatment: If joint replacement surgery is necessary, preoperative and perioperative interdisciplinary care by a team of experienced therapists from the fields of orthopaedics and obesity/type 2 diabetes is required. The Düsseldorf TeDia model in the network of Catholic hospitals in Düsseldorf takes these requirements into account by providing interdisciplinary care for such patients at the orthopaedic centre at St. Vinzenz Hospital Düsseldorf and the West German Diabetes and Health Centre (WDGZ). Patients with pronounced obesity or diabetes mellitus are presented preoperatively at the WDGZ on an outpatient basis, and weight reduction therapy or optimization of the diabetic metabolic situation is initiated. If joint problems persist despite weight reduction or pronounced degenerative changes that require surgery, the WDGZ provides inpatient diabetology care in the orthopaedic clinic with the option of further outpatient follow-up care.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"271-277"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017917","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)].

Orthopadie (Heidelberg, Germany) Pub 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":"https://doi.org/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":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","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

[Obesity in Orthopedics]. [骨科肥胖症]。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-04-01 Epub Date: 2025-03-21 DOI: 10.1007/s00132-025-04608-9

Christoph Schnurr, Christian Lüring

引用次数: 0

[Chronic lateral epicondylopathy : What do we know about tennis elbow?]

Orthopadie (Heidelberg, Germany) Pub Date : 2025-04-01 Epub Date: 2025-03-05 DOI: 10.1007/s00132-025-04630-x

Gerhard Opitz

引用次数: 0

[The connection between back pain and obesity].

Orthopadie (Heidelberg, Germany) Pub Date : 2025-04-01 Epub Date: 2025-01-30 DOI: 10.1007/s00132-025-04612-z

Martin Enge, Clayton N Kraft

引用次数: 0

[Surgical treatment for obesity - metabolic surgery].

Orthopadie (Heidelberg, Germany) Pub Date : 2025-04-01 Epub Date: 2025-01-22 DOI: 10.1007/s00132-024-04607-2

Maximilian Schmeding

{"title":"[Surgical treatment for obesity - metabolic surgery].","authors":"Maximilian Schmeding","doi":"10.1007/s00132-024-04607-2","DOIUrl":"10.1007/s00132-024-04607-2","url":null,"abstract":"Background: Over the past 20 years, surgical treatment of obesity, or metabolic surgery, has established itself as an extremely efficient and sustainable therapy for treating severely overweight patients. Compared to non-surgical weight reduction procedures, surgical techniques have been shown to be superior in all studies, both in terms of short-term and long-term effectiveness. On the other hand, the invasiveness of the procedures is something that many patients view critically.Procedures: Many years of experience with the two most commonly used procedures, laparoscopic sleeve gastrectomy and minimally invasive gastric bypass, show that both procedures are associated with very low morbidity. The comparatively high costs of the surgical procedure are more than offset by the long-term savings in other therapeutic needs (diabetes mellitus, hepatic steatosis, arthritis, osteoarthritis, etc.). The S3 guideline for carrying out metabolic surgical procedures has clear specifications for the criteria to be met. Embedding in a multi-modal concept both pre- and post-operatively is obligatory. The following article provides an overview of the indications, treatment, and aftercare in the field of metabolic surgery.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"283-286"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025849","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

Sports injuries in patients over 70 years of age. Survey in a regional hospital in an Alpine tourist region : DKOU science slam 2024.

Orthopadie (Heidelberg, Germany) Pub Date : 2025-04-01 Epub Date: 2025-03-08 DOI: 10.1007/s00132-025-04635-6

Josefina Engelmann, Sabrina Weber, Michel Conti, Henrik Teuber, Hans-Peter Simmen, Samuel Haupt

引用次数: 0

[Current AWMF guidelines on knee and hip arthroplasty - individual risks].

Orthopadie (Heidelberg, Germany) Pub Date : 2025-04-01 Epub Date: 2025-02-04 DOI: 10.1007/s00132-025-04610-1

Dimitrios Mouselimis, Christian Lüring

{"title":"[Current AWMF guidelines on knee and hip arthroplasty - individual risks].","authors":"Dimitrios Mouselimis, Christian Lüring","doi":"10.1007/s00132-025-04610-1","DOIUrl":"10.1007/s00132-025-04610-1","url":null,"abstract":"Background: In the year 2022, more than 300,000 total hip and knee primary arthroplasties were recorded in the German Arthroplasty Registry. The ever-increasing number of interventions naturally leads to an increase in the absolute number of possible complications. The abundance of internationally available data makes it possible to determine risk factors for postoperative complications.Risk factors: Professional societies involved in the German guidelines in the field of orthopedics place great emphasis on modifiable risk factors, as their adequate management can consequently reduce the likelihood of postoperative complications. One of the most common modifiable risk factors is obesity, with its prevalence remaining consistently high in most developed countries. In the field of orthopedics, the Association of the Scientific Medical Societies in Germany focuses on modifiable risk factors including obesity, diabetes mellitus and smoking.Obesity: In the case of obesity in particular, the guidelines for knee and hip arthroplasty recommend a weight loss attempt for patients with a BMI > 30 kg/m2. A BMI ≥ 40 kg/m2 is considered a \"relative contraindication\" in the guidelines. Shared decision making is emphasized in both guidelines. Ultimately, the particularly critical individual assessment of risk and benefit for each obese patient remains crucial for the final decision.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"261-266"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191569","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