Orthopadie (Heidelberg, Germany)最新文献_第10页

Bone marrow lesions related to bone marrow edema syndromes and osteonecrosis. 与骨髓水肿综合征及骨坏死相关的骨髓病变。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-05-01 Epub Date: 2025-04-22 DOI: 10.1007/s00132-025-04640-9

Gad Shabshin, Nogah Shabshin

{"title":"Bone marrow lesions related to bone marrow edema syndromes and osteonecrosis.","authors":"Gad Shabshin, Nogah Shabshin","doi":"10.1007/s00132-025-04640-9","DOIUrl":"https://doi.org/10.1007/s00132-025-04640-9","url":null,"abstract":"Bone marrow lesions (BML) are abnormalities in the bone marrow identified on magnetic resonance imaging (MRI) and can generally be classified as traumatic or atraumatic. This review focuses on atraumatic bone marrow edema syndromes (BMES) and their imaging evaluation. The MRI remains the modality of choice for assessing BMES, particularly using fluid-sensitive sequences although other sequences such as Dixon and T1-weighted imaging can be of further assistance. Emerging evidence supports dual-energy CT (DECT) as a reliable alternative, with high sensitivity and specificity for detecting bone marrow edema. The term BMES is a collective term for conditions, such as transient osteoporosis (TO) and regional migratory osteoporosis (RMO), predominantly affect weight-bearing bones in middle-aged individuals and pregnant or postpartum females. Subchondral insufficiency fractures of the knee (SIFK) are a key subset of BMES. These fractures most commonly involve the medial femoral condyle (MFC) and are associated with risk factors, such as meniscal root tears and extrusion of the meniscal body. The MRI findings typically include bone marrow edema-like signals and subchondral fracture lines, with additional features, such as secondary osteonecrosis in advanced cases. Prognostic indicators are crucial for stratifying patients and guiding management. Low-grade or reversible lesions often resolve with conservative treatment, whereas high-grade or irreversible lesions may require surgical intervention.Avascular necrosis, another atraumatic BML entity, differs from BMES by its association with systemic factors, such as steroid use or alcohol abuse. Accurate imaging, particularly in the early stages, is vital to distinguish between reversible and irreversible lesions, facilitating timely and appropriate management.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":"54 5","pages":"324-331"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058820","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

[The value of physical therapy modalities for osteonecrosis and bone marrow edema : Current study situation and practical applicability in everyday clinical practice]. 【骨坏死、骨髓水肿物理治疗方式的价值：研究现状及在日常临床实践中的实用性】。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-05-01 Epub Date: 2025-03-03 DOI: 10.1007/s00132-025-04624-9

Lutz Linneweber

引用次数: 0

[Etiology of osteonecrosis and bone marrow edema]. 【骨坏死和骨髓水肿的病因学】。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-05-01 Epub Date: 2025-02-24 DOI: 10.1007/s00132-025-04629-4

Dietrich Pape, Ben Bertemes, Cristina Dinis, Julien Dessard, Tom Gryson, Yorick Fonteyn, Charlotte Deprouw, Romain Seil, Alexander Hoffmann

{"title":"[Etiology of osteonecrosis and bone marrow edema].","authors":"Dietrich Pape, Ben Bertemes, Cristina Dinis, Julien Dessard, Tom Gryson, Yorick Fonteyn, Charlotte Deprouw, Romain Seil, Alexander Hoffmann","doi":"10.1007/s00132-025-04629-4","DOIUrl":"10.1007/s00132-025-04629-4","url":null,"abstract":"Background: The frequent use of magnetic resonance imaging (MRI) introduced \"bone marrow edema\" (BME) as a descriptive radiological term for hyperintense signal changes in fluid-sensitive sequences. With the optimization of MRI soft tissue contrast, BME has evolved into a valid prognostic indicator associated with pain genesis, trauma, mechanical overload, and progressive cartilage and joint destruction.Diagnostics: Both osteonecrosis and BME manifest in early MRI as intraosseous fluid accumulation, characterized by hyperintense signals in T2-weighted and STIR sequences. Conventional radiography and computed tomography (CT) are limited in BME detection due to the absence of relevant density alterations or structural osseous lesions early on.Classification: Although BME is not pathognomonic for osteonecrosis, it represents the initial phase of every primary osteonecrosis. BME can be transient (transitory osteoporosis) and regress without residuals or serve as a prodromal stage of manifest osteonecrosis.Pathophysiology: Primarily, it represents a non-specific reaction of bone marrow to various noxious stimuli such as trauma, mechanical overload, inflammatory processes, vascular insufficiency, or metabolic dysregulations. This review explores the pathophysiological mechanisms underlying BME, its clinical significance for osteonecrotic joint diseases, and its role in pain genesis.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"332-341"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484867","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

[Sonography of fractures in childhood-Practice-oriented case examples of frequent entities]. [儿童骨折的超声检查-以实践为导向的频繁实体病例]。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-05-01 Epub Date: 2025-03-31 DOI: 10.1007/s00132-025-04642-7

Eduardo Sampaio, Jörg Scherer, Jakob Hoffmanns, Jakob Mayr, H-G Palm

引用次数: 0

[Bone marrow edema and osteonecrosis in sport : Relevance, prognosis and therapy]. [运动中的骨髓水肿和骨坏死：相关性、预后和治疗]。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-05-01 Epub Date: 2025-02-28 DOI: 10.1007/s00132-025-04626-7

Matthias Brockmeyer, Henning Madry, Patrick Orth

{"title":"[Bone marrow edema and osteonecrosis in sport : Relevance, prognosis and therapy].","authors":"Matthias Brockmeyer, Henning Madry, Patrick Orth","doi":"10.1007/s00132-025-04626-7","DOIUrl":"10.1007/s00132-025-04626-7","url":null,"abstract":"Background: Sports activities lead to loading stress for the osteochondral unit of the joints, especially for the lower extremity. Athletes frequently suffer from articular cartilage defects, meniscus and ligament injuries, which are often associated with subchondral bone marrow edema and osteonecrosis.Objectives: Presentation of relevance, prognosis and therapeutic options for bone marrow edema and osteonecrosis in sport.Material and methods: This review describes the clinical relevance, prognostic aspects and potential treatment options for bone marrow edema and osteonecrosis in athletes.Results: Subchondral bone marrow edema and osteonecrosis frequently occur in athletes. Most commonly, they are caused by mechanical joint overload due to sporting activities, but they are also found posttraumatically and postoperatively. Their clinical relevance to athletes remains unclear. A stepwise treatment concept includes non-surgical as well as surgical treatment options for symptomatic bone marrow edema and osteonecrosis in sport with different clinical prognoses depending on severity and location of the lesion.Conclusions: Bone marrow edema and osteonecrosis may have a relevant impact on the joint function in athletes. They play a decisive role in the rehabilitation following joint injuries and surgeries and are associated with the clinical outcomes following joint injuries and have critical influence on the return to sporting activities.Level of evidence: IV, narrative review.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"342-348"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532187","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

[Subchondral pathologies: current conservative treatment concepts]. 【软骨下病变：当前保守治疗理念】。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-05-01 Epub Date: 2025-04-28 DOI: 10.1007/s00132-025-04638-3

Patrick Orth, Henning Madry

引用次数: 0

Thrombophilia, hypofibrinolysis and osteonecrosis. 血栓症，低纤溶和骨坏死。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-05-01 Epub Date: 2025-02-19 DOI: 10.1007/s00132-024-04606-3

Charles J Glueck

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

[The weight-loss injection : An orthopaedic overview]. 【减肥注射：骨科综述】。

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

[Chronic lateral epicondylopathy : What do we know about tennis elbow?] 慢性外侧上髁病变：我们对网球肘了解多少？］

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